What is the expected timeframe for a pediatric patient to urinate after surgery?

From the Guidelines

Pediatric patients should urinate within 6-8 hours after surgery. The expected timeframe for a pediatric patient to urinate after surgery can vary based on several factors, including the child's age, type of surgery, anesthesia used, and fluid status [no direct evidence from 1]. Infants and younger children typically void sooner than older children. If a child hasn't urinated within 8 hours post-surgery, medical evaluation is warranted. Factors that may delay urination include pain medications, regional anesthesia, surgical trauma to areas near the urinary tract, and inadequate fluid intake. Some key points to consider in the post-operative care of pediatric patients include:

• Ensuring adequate hydration to promote urination
• Providing privacy and using comfort measures like warm baths or running water sounds to help the child feel more at ease
• Considering early ambulation if appropriate to help stimulate the urination reflex
• Monitoring intake and output closely during the post-operative period It's also important to note that, according to the guidelines for managing bladder injuries 1, suprapubic cystostomy is recommended for pediatric patients, which may affect the timing of urination after surgery. However, this is more relevant to cases involving bladder trauma rather than routine post-surgical care. In general, the inability to void after surgery can occur due to temporary impairment of bladder muscle function and altered sensation of bladder fullness caused by anesthetics, as well as pain and anxiety inhibiting the normal urination reflex.

From the Research

Expected Timeframe for Urination after Surgery

The expected timeframe for a pediatric patient to urinate after surgery is not explicitly stated in the provided studies. However, the studies provide information on postoperative urinary retention (POUR) and its management.

Factors Influencing Urination after Surgery

• The type of surgery, anesthesia, and comorbidities can influence the development of POUR 2.
• The use of regional anesthesia, anesthesia time >2 h, and emergency surgery are independent risk factors for POUR 3.
• The lack of pre-operative voiding is also a risk factor for POUR 3.

Management of Postoperative Urinary Retention

• Ultrasound can be used to assess urinary bladder volume and guide the management of POUR 2.
• Catheterization is generally regarded as the optimal management method, but it is associated with risks 4.
• Pharmacological treatment of POUR, such as cholinergic agents and intravesically administered prostaglandin, may be effective in some cases 4.
• The goal of management is to decompress the bladder to avoid long-term damage to bladder integrity and function 5.

Pediatric Patients

• Pediatric patients are less likely to return to the emergency department postoperatively compared to adults 6.
• However, pediatric patients are more likely to require only reassurance, while adults are more likely to require hospital admission 6.