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PubMed2000

Effect of cement type on retention of a tapered post with a self-cutting double thread.

OBJECTIVES: The aim of this in vitro study was to examine the effect of varying the cement type on the retention of a prefabricated tapered titanium post with a self-cutting double thread (Perma-tex activ). METHODS: A total of 130 suitable roots from extracted human permanent teeth were selected. Post holes were prepared using the instruments supplied with the post system. One-hundred-twenty posts (medium size) were luted with one of four luting agents: a zinc-phosphate cement (Harvard), a glass-ionomer cement (Ketac Cem), a compomer luting agent (Dyract Cem), and a new capsulated composite luting system (Compolute). The cement groups were subdivided into three treatment groups with 10 posts each: group 1 (4-week water storage at 37 degrees C), group 2 (4-week water storage at 37 degrees C, 4000 cycles 5-55 degrees C), group 3 (4-week water storage at 37 degrees C, 4000 cycles 5-55 degrees C, 3 x 4 min mechanical stress: 40N vibrations). Another 10 posts inserted without cement and stored like group 1 served as a control. Retention was measured on a universal testing machine (Zwick Z050/TH3A) with a crosshead speed of 0.1cm/min. Data were analyzed using ANOVA with a Bonferroni or Tamhane adjustment for multiple comparisons (significance level alpha=0.05). RESULTS: In group 1, Dyract Cem was significantly more retentive than the other three cements and the control group (no cement). In group 2, Compolute demonstrated significantly higher retention than Harvard and Ketac Cem. In group 3, Compolute, Dyract Cem, and Ketac Cem obtained higher retentive values than Harvard without differing from one another. Within the cement groups, thermocycling (group 2) caused a significant decrease in retention compared to group 1 only for Dyract Cem. All cements except Compolute were different from group 1 after a combination of thermocycling and mechanical stress (group 3). CONCLUSIONS: The retention of the tapered post with a self-cutting double thread was significantly influenced by the cement type used.

Analysis of Variance↗

PubMed1999

Peripheral steroid sulfatase inhibition potentiates improvement of memory retention for hippocampally administered dehydroepiandrosterone sulfate but not pregnenolone sulfate.

Dehydroepiandrosterone sulfate (DHEAS) improves memory retention when administered peripherally. Estrone-3-O-sulfamate (EMATE), a steroid sulfatase inhibitor, potentiates the effect of DHEAS on memory retention such that lower doses of DHEAS improve memory retention. It is not clear if this effect is mediated by both compounds entering the central nervous system. In the current studies, mice were trained to avoid footshock in a T-maze and memory retention was tested 1 week later. DHEAS, injected into the hippocampus after training, improved memory retention in a dose-dependent manner. In previous studies, pregnenolone sulfate (PREGS) improved memory retention when injected into the hippocampus. EMATE, administered peripherally, potentiated the effect of centrally administered DHEAS on memory retention. However, EMATE did not potentiate the effect of centrally administered PREGS. It was concluded that EMATE, acting peripherally, increased plasma levels of DHEAS which entered the brain and added to the effect of centrally administered DHEAS. The failure of EMATE to potentiate PREGS is discussed.

Animals↗

PubMed1982

Serotonin and fear retention in the rat.

p-Chloroamphetamine (PCA), which releases serotonin (5-HT) stores in brain regions, injected (5 mg/kg, ip) into male rats 40 min prior to the presentation of four inescapable shocks (.065 W) in the right-hand compartment of a normal shuttle box resulted in a profound fear-retention deficit as characterized by the total loss of the freezing and immobility posture that is normally the aftermath of shock presentation; zimelidine (10 mg/kg) 60 min before PCA completely blocked the disruption of fear. The "PCA effect" on fear retention was found at the 2.5 mg/kg but not quite at the 1.25 mg/kg dose, and when PCA (5 mg/kg) had been injected at least 8 hr before conditioning. The selective 5-HT uptake inhibitors zimelidine and fluoxetine, but not the noradrenaline (NA) uptake inhibitor desipramine, blocked the PCA effect, as did the 5-HT antagonist methergoline, but not the selective dopamine antagonist pimozide. A total retention impairment with a conditioning-testing delay of just 60 min was also evidenced, and the administration of PCA up to 2 hr before fear-retention testing also produced the retention deficit; these findings suggest some "retrieval failure." The 5-HT specificity of the PCA effect on fear retention was established by the demonstration that 5-HT-depleted rats (PCA, 2 X 10 mg/kg), but not NA-depleted rats, showed a nearly complete blockade of the fear-retention deficit. These experiments describe a role for 5-HT in both memory storage and retrieval processes.

Animals↗

PubMed2000

Effect of prefabricated metal post-head design on the retention of various core materials.

Retention of various post heads to core restorative materials is an important factor in the selection of prefabricated post systems and restorative materials for the restoration of endodontically treated teeth. This study examines the retention of a post-core prefabricated system in relation to core material and post-head design. A total of 60 samples were prepared using two different post systems (ParaPost Plus (PP) and ParaPost Unity (PU), with amalgam, composite or glass-ionomer as one of the core materials. The samples were tested using the Instron testing machine. The PP was superior to the PU prefabricated post with respect to the retention of various core materials. Retention values in descending order of magnitude were found to be: composite, amalgam and glass-ionomer (significantly lower). The rhomboid serrated design of PP was superior in retention to the rounded smooth UP system. Composite material proved to be superior in retention, closely followed by amalgam, with glass-ionomer significantly less retentive.

Analysis of Variance↗

PubMed1998

The management of men with acute urinary retention. National Prostatectomy Audit Steering Group.

OBJECTIVES: To determine the outcome of men with acute urinary retention undergoing prostatectomy and to assess whether discharge with a catheter before subsequent planned re-admission for prostatectomy had an adverse effect on outcome. PATIENTS AND METHODS: A prospective cohort study was conducted of all men undergoing prostatectomy in five health care regions over a 6-month period in 56 hospitals where prostatectomies were performed under the care of 103 surgeons. The study included 3966 men undergoing prostatectomy, of whom 1242 presented with acute urinary retention; the complication rates and symptomatic outcome were assessed. RESULTS: Compared with those who underwent elective prostatectomy for symptoms alone, men presenting with acute retention had an excess risk of death at 30 days (relative risk [RR], 26.6, 95% confidence interval [CI], 3.5-204.5) and at 90 days after operation (RR 4.4, 95% CI 2.5-7.6), and an increased risk of perioperative complications. Although men with retention were older, had larger glands and had more comorbidity, these factors did not totally explain the excess risk. The final symptomatic outcome of men with acute retention was no different from that of men presenting for elective treatment. Men with retention who were managed by initial catheterization, sent home and subsequently re-admitted for planned operation had similar pretreatment characteristics, post-operative complications and outcomes to those who were kept in hospital throughout, although the men kept in hospital had a total increased length of stay. CONCLUSIONS: Men with acute retention have a high risk of developing complications after undergoing prostatectomy. We were unable to confirm that a short-term period of catheter drainage at home before re-admission for planned surgery carried increased risks of peri-operative complications.

Acute Disease↗

PubMed2001

Characteristics of protein excretion in patients with acute urinary retention.

OBJECTIVE: To evaluate changes in protein leakage in the glomerular filtration barrier, and in the ability of the tubule to reabsorb proteins during and after acute urinary retention (AUR). PATIENTS AND METHODS: Glomerular and tubular function was investigated in 24 men during AUR (mean age 68 years, mean retention time 31 h and mean retention volume 1140 mL) who were then followed for 6 months by measuring the urinary excretion of glomerular and tubular proteins, and the glomerular filtration rate (GFR). Retention was relieved by inserting a suprapubic catheter and the cause of retention treated one month later. No patient had a previous renal disease or diabetes. RESULTS: During AUR, and after 1 and 6 months, albuminuria was detected in 100%, 92% and 54% of patients, and increased excretion of alpha1-microglobulin in 52%, 36% and 58%, of IgG in 79%, 58% and 40%, and of IgG4 in 67%, 42% and 20%, respectively. The mean GFR was normal during retention and during the follow-up. CONCLUSION: AUR causes disturbances in both the glomerular filtration and tubular reabsorption of proteins. Albuminuria and increased excretion of IgG, IgG4 and alpha1-microglobulin occurred in most patients during AUR. After relieving retention, the albuminuria and elevated alpha1-microglobulin excretion persisted, indicating slight glomerular dysfunction and a permanent defect in the proximal tubule to reabsorb proteins. This could be caused partly by previous chronic obstruction. AUR should be relieved immediately and the basic cause treated effectively to prevent further deterioration of renal function.

Acute Disease↗

PubMed2003

Corticosteroid use after prostate brachytherapy reduces the risk of acute urinary retention.

OBJECTIVES: To evaluate the role of short-term steroids after prostate brachytherapy to reduce oedema and thus the risk of urinary retention associated with brachytherapy, as this can require surgical intervention and may even result in incontinence. PATIENTS AND METHODS: A retrospective review was conducted on 400 consecutive patients with early-stage prostate cancer who underwent ultrasonography-guided transperineal brachytherapy. Androgen deprivation was given to 146 patients for 3 months before the implant and 280 received a 2-week course of dexamethasone (4 mg twice daily for 1 week then 2 mg twice daily). Forty-five patients developed acute urinary retention at a median of 12 days after implantation. Univariate and multivariate analyses were used to evaluate the potential risk factors for urinary retention. RESULTS: Acute urinary retention developed in 11.1% of the patients and the risk was predicted by increasing prostate volume at the time of diagnosis. This risk was higher (18.8%) for men receiving no dexamethasone and lower (8.2%) for those who did. In the multivariate analysis the volume at diagnosis and the use of dexamethasone remained significant. The use of steroids counterbalanced the effect of increasing prostate volume on the incidence of retention. The risk of retention was higher in those men receiving androgen deprivation to shrink their prostates than in those whose prostates were of suitable size for implantation at the time of diagnosis. CONCLUSION: Reducing prostate volume by androgen deprivation before brachytherapy may be less important in preventing brachytherapy-related urinary retention than the use of corticosteroids to reduce oedema afterward.

Adult↗

PubMed2002

Four-year follow-up of women who were diagnosed to have postpartum urinary retention.

OBJECTIVE: The purpose of this study was to evaluate the long-term prevalence of urinary incontinence in women with postpartum urinary retention. STUDY DESIGN: A telephone interview was conducted by contacting a cohort of 691 women who delivered vaginally 4 years ago, of which 101 women had been diagnosed as having postpartum urinary retention. A structured telephone interview consisted of 9 questions on the possible outcomes of postpartum urinary retention. RESULTS: Of the original cohort of 691 women, 394 women were contacted. Seventy-three women had had postpartum urinary retention, and 321 women had not. In women who had had postpartum urinary retention, the prevalence of the outcome variables were urinary stress incontinence (28.8%), fecal incontinence (2.7%), frequency (39.1%), nocturia (65.2%), urgency (26.1%), urge incontinence (26.1%), and coital incontinence (13%). Analyses showed that there was no significant difference between women with and without urinary retention. CONCLUSION: Women who had had postpartum urinary retention did not have a higher prevalence of urinary stress incontinence.

Female↗

PubMed2003

Effect of a fluoride varnish on the margin leakage and retention of luted provisional crowns.

STATEMENT OF PROBLEM: Provisional crowns cemented with provisional luting agents are susceptible to washout, margin leakage, and secondary caries when placed for a prolonged period. PURPOSE: This study was conducted to determine the effect of combining a varnish containing 2.26% NaF with 2 provisional luting agents on the margin leakage and retention of provisional crowns. MATERIAL AND METHODS: Acrylic resin provisional crowns were fabricated for 8 shoulder-prepared molars. The eight provisional (N=24) crowns were luted individually with Temp-Bond (TB), Freegenol (FG), or Duraphat (DU). Specimens were thermocycled 500 times (5 degrees and 60 degrees C) with a 1-minute dwell time, stored in 100% relative humidity at 37 degrees C for 6 days, and then immersed in a 0.5% Gentian violet solution for 24 hours. Seven days after cementation, a removal test of the crowns (shear retention test) was conducted with a universal testing machine at a crosshead speed of 5 mm/min. Retention was determined as the maximum recorded force needed for crown dislodgment. DU varnish was applied to the inner surface of the dislodged crowns with no removal of the cement layer TB, FG (N=16). The crowns were relined with a 0.5-mm layer of acrylic resin and luted with a combination of luting agent and DU (TB, FG) N=16. No luting agent (NC) served as the control (N=8). Results were analyzed with the Wilcoxon matched-pairs signed-ranks test. Leakage at the margins was assessed with a 4-level dye penetration scale, and statistical differences were identified with a chi(2) test. All hypothesis testing was conducted at the 95% level of confidence. RESULTS: The mean 7-day retention forces were as follows: 44.5 N (Temp-Bond), 51.6 N (Freegenol), and 35.9 N (Duraphat). There were no significant differences among these values. Duraphat combined with Freegenol decreased the retention of provisional crowns, but Duraphat combined with Temp-Bond increased the retention of provisional crowns by 69-145%. Duraphat alone and in combination with both provisional luting agents significantly reduced margin leakage (P<.05). The least margin leakage was evident when the provisional crowns were luted with Duraphat alone. CONCLUSION: With regard to retention and margin leakage, the results of this study suggest that Duraphat varnish can be successfully used as provisional luting agent for single provisional crowns.

Acrylic Resins↗

PubMed1995

Age-related retention of skilled memory search: examination of associative learning, interference, and task-specific skills.

Young and older adults performed skilled memory search after either a 3- or 6-month retention interval. Participants were first trained in consistent-mapping (CM) memory search; then, one of the search conditions was subjected to interfering processing activity prior to the retention interval. Retention testing simultaneously examined situations where interfering processing activity either did or did not intervene between original learning and retention testing. In addition, general task-specific learning was assessed. Results indicate that (a) old and young adults equally retained general, task-specific skills; (b) old adults' performance declined more than young adults' performance for trained CM stimuli; (c) when an interfering processing activity was inserted prior to the retention interval, old adults' performance declined disproportionately more than young adults' performance, especially when compared to the task not subjected to such interference; and (d) for both old and young adults all initial retention deficits were quickly eliminated within retention retraining.

Adolescent↗

PubMed2005

Predictors of engagement and retention into a parent-centered, ecodevelopmental HIV preventive intervention for Hispanic adolescents and their families.

OBJECTIVE: This study examined predictors of engagement and retention into a parent-centered, ecodevelopmental HIV preventive intervention for Hispanic adolescents and their families. The influence of retention on changes in adolescent HIV-risk attitudes was also examined. METHODS: Participants in this study were 91 Hispanic adolescents and their primary parents. Structural equation modeling was used to identify (a) predictors of initial engagement, (b) the effects of group processes on retention, and (c) the effects of retention on change HIV-risk attitudes in adolescents. RESULTS: Although some participant characteristics predicted engagement, the parent-facilitator relationship quality at the initial contact was found to be the strongest predictor of engagement. Furthermore, within-group processes such as group cohesion positively predicted retention. Finally, parent retention predicted decreases in adolescent HIV-risk attitudes. CONCLUSIONS: The results may have important implications for engagement and retention in parent-centered interventions, as well as for reducing risks for HIV transmission in Hispanic adolescents. Implications for services research are also discussed.

Adolescent↗

PubMed2003

Factors predictive of urinary retention after a tension-free vaginal tape procedure for female stress urinary incontinence.

PURPOSE: We performed this study to evaluate factors related to urinary retention after a tension-free vaginal tape (TVT) procedure for female stress urinary incontinence. MATERIALS AND METHODS: We retrospectively analyzed the records of 375 women with a followup of at least 6 months from among patients who underwent the TVT procedure between March 1999 and May 2002 at our institution. We analyzed multiple parameters, including patient characteristics, symptoms and urodynamic studies, using univariate and multivariate regression analyses with respect to postoperative urinary retention, as defined by the need for intermittent catheterization for at least 3 days after the procedure. All patients in the nonretention (343) and retention (32) groups answered a global satisfaction question. RESULTS: In answer to a global satisfaction question 338 of the 375 patients (90.1%) favored the procedure. Univariate analysis demonstrated that patient mean age, parity, peak urinary flow and a history of hysterectomy predicted urinary retention. However, on multivariate analyses the peak urinary flow rate was the only significant independent predictive factor (p = 0.007). While 28 patients (87.5%) in the retention group regained normal voiding without a specific procedure, 4 required tape release or cutting within 3 month of surgery. The global satisfaction question showed a significant difference between the nonretention and retention groups (91.5% vs 75% satisfaction, p = 0.03). CONCLUSIONS: An accurate measurement of the peak urinary flow rate could predict women at risk for postoperative urinary retention that compromises global satisfaction after the highly curative TVT procedure.

Female↗

PubMedDate not supplied

Protein synthesis-dependent memory and neuronal enhancement in Hermissenda are contingent on parameters of training and retention.

Following contiguous pairings of light and rotation, light alone elicits a conditioned contraction of Hermissenda's foot, indicative of an associative memory. After a 5-min retention interval, this conditioned response was evident following two or nine (but not one) conditioning trials but persisted for 90 min only after nine trials. In vivo incubation of animals in the protein synthesis inhibitor anisomycin (ANI; 1 microM) did not affect the conditioned response at the 5-min retention interval but significantly attenuated conditioned responding at the 90-min interval even following nine training trials. Deacetylanisomycin (DANI; 1 microM; an inactive form of anisomycin) had no effect on either 5- or 90-min retention. In a companion procedure, groups of isolated nervous systems were exposed to comparable light and rotation pairings, and the B photoreceptors (considered a site of storage for the associative memory) underwent electrophysiological analysis. An increase in neuronal excitability (indexed by depolarizing voltage responses to injected current) in the B photoreceptors paralleled the expression of conditioned responding in intact animals, that is, two training trials produced a short-term increase in excitability that dissipated within 45 min, whereas nine trials produced a persistent (at least 90-min) increase in excitability. In a fmal experiment, isolated nervous systems were exposed to nine training trials, and ANI or DANI was either present in the bathing medium before and during training or was introduced 5 min after training. Following training in ANI, a short-term (5- to 45-min) but not persistent (90-min) increase in excitability in the B photoreceptors was observed. ANI had no effect on either the short-term or persistent increase in excitability if the drug was applied 5 min after the last (ninth) training trial, and DANI had no effect on training-induced increases in excitability at any retention intervals. These results suggest that short-term retention in Hermissenda is protein synthesis independent but that new protein synthesis initiated during or shortly after the training event is necessary for even 90-min retention. Moreover, these results indicate that under some conditions, a critical threshold of training must be exceeded to initiate protein synthesis-dependent retention.

Animals↗

PubMed2002

Retention mechanisms and prosthetic complications of implant-supported mandibular overdentures: long-term results.

BACKGROUND: Although many studies report high survival rates of mandibular implants supporting an overdenture, complications with prostheses and the need for prosthetic maintenance are not so well documented. PURPOSE: The purpose of the present study was to analyze three categories of prosthetic complications in relation to the type of retention mechanism for overdenture connection to the implants (ie, rigid or resilient). MATERIALS AND METHODS: One hundred nineteen patients with a total of 258 implants participated in the study. They had been monitored regularly during an observation period of 5 to 15 years (mean 9.3 yr). Seventy-five patients had a resilient retention device (ball anchors or a round clip bar); 44 patients had a rigid bar with or without distal extensions. The incidence and rate of complications were calculated for the overall- and for the 2- and 5-year observation periods. Comparisons were made between the three categories of maintenance and the two types of retention. A Kaplan-Meier analysis was applied for calculations of changes of the retention mechanism. RESULTS: The mean number of complications per overdenture during the entire observation period was 3.5; this did not differ statistically between the two retention groups. Some significant differences were found only for the 2- and 5- year period. Broken, loose, or lost female parts were more frequently observed with resilient devices, as were repairs and relining of the resin denture base, whereas tightening of bar retainers was more typical with rigid bars. A change from a resilient retention device to a rigid bar was performed more often than vice versa but not at a statistically significant level. CONCLUSION: Although these long-term results do not indicate a significant difference between the retention groups, a slight superiority of the rigid bar is suggested.

Adult↗

PubMed1996

The effect of endodontic access cavity preparation and subsequent restorative procedures on molar crown retention.

Preparation of an endodontic access cavity through a full crown may affect its retention. This study was undertaken to investigate the effects on molar crown retention of endodontic access cavities and their subsequent restoration. Thirty human molars were mounted in resin, crown preparations were cut and their surface areas were determined. Vented metal copings were cemented with zinc phosphate and the forces required to displace each coping were measured using a tensile-testing machine. The copings were recemented, access cavities were cut and their surface areas determined prior to the displacement forces being re-measured. The copings were recemented, assigned to two groups, and the access cavities were restored--Group 1 with amalgam; Group 2 with glass ionomer (GIC). Displacement forces were re-measured and the copings were recemented. The occlusal margins of the access cavities were bevelled and restored again prior to displacement forces being remeasured. Mean displacement forces were - Group 1: Original (kg force), 37.86 +/- 3.97; After access cavity, 29.28 +/- 3.22; Amalgam, 50.21 +/- 4.71; Amalgam + bevel, 46.45 +/- 6.21. Group 2: Original, 42.77 +/- 4.49; After access cavity, 39.25 +/- 5.91; GIC, 48.11 +/- 3.55; GIC + bevel, 39.63 +/- 5.31. Statistical analyses with paired t tests showed that retentive values with access cavities were significantly lower than with intact crowns. Amalgam or GIC restorations increased retention beyond original values, significantly with amalgam. Bevelled occlusal margins decreased retention of crowns with restored access cavities but this was not significantly different from the original values. A significant relationship existed between total surface areas of the crown preparations, areas of the occlusal tables, and retentive values for crowns without access cavities. The access cavity area, as a proportion of the total area of the preparation, was related to the decrease in retention.

Cementation↗

PubMed2003

Student retention of course content is improved by collaborative-group testing.

We recently reported that collaborative testing (i.e., group test taking) increased student performance on quizzes. It is unknown, however, whether collaborative testing improves student retention of course content. Therefore, this study was designed to test the hypotheses that collaborative-group testing improves student retention of course content. To test this hypothesis, our undergraduate exercise physiology class of 38 students was randomly divided into two groups: group A (n = 19) and group B (n = 19). During exam 1, students from both groups answered questions in the traditional format as individuals. Immediately after completing the exam as individuals, students from group A answered a randomly selected subset of questions from exam 1 in groups of two (1 group had 3 students) to test the effectiveness of collaborative-group testing on test performance and level of student retention. On the next exam (exam 2, 4 wk later), students from both groups answered questions in the traditional format as individuals and responded to the same subset of questions from exam 1. The subset of questions was analyzed to determine the level of retention of the original test material. In addition, immediately after completing the exam as individuals, students from group B answered a randomly selected subset of questions from exam 2 in groups of two (1 group had 3 students). Finally, on the next exam (exam 3, 4 wk later), students from both groups answered questions in the traditional format as individuals and responded to the same subset of questions from exam 2. This protocol followed a randomized crossover design to control for time and order effects. Student retention of course content was reduced when students completed the original examinations individually. In sharp contrast, student retention was improved (P < 0.05) when students completed the original examinations in groups. Results suggest that collaborative testing is an effective strategy to enhance learning and increase student retention of course content.

Cooperative Behavior↗

PubMed2001

Eosinophilic cystitis presenting as urinary retention.

OBJECTIVE: To evaluate the incidence, etiology, diagnosis, therapy and results in patients with eosinophilic cystitis (EC), with special attention to patients with urinary retention as presenting symptom. PATIENTS AND METHODS: Between 1988 and 1999, 3 patients with EC were diagnosed. One patient presented with urinary retention, without other symptoms. All patients were evaluated for symptoms, urine culture, hematology including cell differentiation, blood chemistry, cystoscopy and intravenous urography. The international literature was reviewed for incidence, etiological factors, diagnostic procedures, therapies and outcome of EC presenting with urinary retention. RESULTS: Two male patients presented with pain, frequency of micturition and nocturia. One female patient presented with urinary retention. One patient had an urinary tract infection. One patient showed eosinophilia of the peripheral blood. Intravenous urography revealed hydroureteronephrosis in 2 patients (1 unilateral and 1 bilateral). Cystoscopy showed tumor-like lesions in 2 patients. Therapy consisted of oral or intravesical corticosteroids or transurethral resection of the lesions. All patients were cured. A review of the literature revealed that 14 patients with EC (10%) presented with urinary retention; the majority (79%) being children and women. All patients returned to normal miction following therapy. CONCLUSIONS: The clinical presentation of EC is varied. When the lesion is located at or near the bladder neck, it may present as urinary retention. In children and women with urinary retention, EC must be considered in the differential diagnosis. Corticosteroids are the mainstay of efficient therapy.

Adrenal Cortex Hormones↗

PubMed2005

Predictive factors of early postoperative urinary retention in the postanesthesia care unit.

UNLABELLED: Urinary retention is a common postoperative complication associated with bladder overdistension and the risk of permanent detrusor damage. The goal of this study was to determine predictive factors of early postoperative urinary retention in the postanesthesia care unit (PACU). We prospectively collected, in 313 adult patients, variables including age, gender, previous history of urinary tract symptoms, type of surgery and anesthesia, intraoperative administration of anticholinergics, amount of intraoperative fluids, IV morphine titration, and bladder volume on entry to the PACU. For each patient, bladder volume was measured by ultrasound on entry and before discharge from the PACU. Urinary retention was defined as a bladder volume larger than 600 mL with an inability to void within 30 min. Predictive factors were identified by multivariate analysis. The incidence of urinary retention in the PACU was 16%. In the multivariate analysis only the amount of intraoperative fluids (>or=750 mL; P = 0.02; odds ratio = 2.3), age (>or=50 yr; P = 0.008; odds ratio = 2.4), and bladder volume on entry to PACU (>or=270 mL; P = 0.0001; odds ratio = 4.8) were found to independently increase the risk of urinary retention. Considering the clinical impact of undiagnosed postoperative urinary retention, these results suggest systematic evaluation of bladder volume with a portable ultrasound device in the PACU, especially in patients with risk factors. IMPLICATIONS: In this observational study, the ultrasound monitoring of bladder volume in the postanesthesia care unit (PACU) revealed that postoperative urinary retention occurred with an incidence of 16%. Age (>or=50 yr), amount of intraoperative fluid volume (>or=750 mL), and bladder volume on entry to PACU (>or=270 mL) were independent predictive factors for this complication.

Adolescent↗