{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T02:59:30Z","timestamp":1778813970955,"version":"3.51.4"},"reference-count":16,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2022,8,29]],"date-time":"2022-08-29T00:00:00Z","timestamp":1661731200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Epidural analgesia is effective and an accepted treatment for postoperative pain. Urinary retention is a known complication, but its description is mostly in the adult literature. Management of urinary catheter (UC) placement and removal is an important consideration in children receiving epidural analgesia. This is a single-center, retrospective observational study which examined UC management in children undergoing lower extremity orthopedic surgery under general anesthesia with or without epidural analgesia from January 2019\u2013June 2021. Of 239 children included, epidural analgesia was used in 57 (23.8%). They were significantly younger and had more co-morbidities. In total, 75 UCs were placed in the OR, 9 in the ward, and 7 re-inserted. UC placement in the epidural group was more common (93% vs. 17%, p &lt; 0.001) and remained longer (3 days vs. 1 day, p = 0.01). Among children without intra-operative UC, ward placement was more common in the epidural cohort (60% vs. 1.6%, p = 0.007). OR UC placement and ward re-insertion were more common in children with neuromuscular disease (61% vs. 22%, p &lt; 0.001), (17% vs. 3%, p = 0.001), respectively. Based on these findings, we hypothesize that it is justifiable to routinely place a UC intra-operatively in children who undergo hip or lower extremity surgery and are treated with epidural analgesia, and caution is advised before early UC removal in orthopedic children with NMD.<\/jats:p>","DOI":"10.3390\/children9091316","type":"journal-article","created":{"date-parts":[[2022,8,29]],"date-time":"2022-08-29T21:01:31Z","timestamp":1661806891000},"page":"1316","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Postoperative Urinary Catheterization in Children Treated with or without Epidural Analgesia after Orthopedic Surgery: A Retrospective Review of Practice"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4255-9385","authenticated-orcid":false,"given":"Yotam","family":"Lior","sequence":"first","affiliation":[{"name":"Divisiona of Anesthesia, Intensive Care, and Pain Medicine, Tel-Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6423906, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shimon","family":"Haim","sequence":"additional","affiliation":[{"name":"Divisiona of Anesthesia, Intensive Care, and Pain Medicine, Tel-Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6423906, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Idan","family":"Katz","sequence":"additional","affiliation":[{"name":"Divisiona of Anesthesia, Intensive Care, and Pain Medicine, Tel-Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6423906, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barry","family":"Danino","sequence":"additional","affiliation":[{"name":"Department of Pediatric Orthopedic Surgery, Dana Dwek Children\u2019s Hospital, Tel-Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6423906, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3769-6606","authenticated-orcid":false,"given":"Yuval","family":"Bar-Yosef","sequence":"additional","affiliation":[{"name":"Department of Pediatric Urology, Dana Dwek Children\u2019s Hospital, Tel-Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6423906, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Margaret","family":"Ekstein","sequence":"additional","affiliation":[{"name":"Divisiona of Anesthesia, Intensive Care, and Pain Medicine, Tel-Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6423906, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,8,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1166","DOI":"10.1097\/00000542-200311000-00025","article-title":"Efficacy, safety, and pharmacokinetics of levobupivacaine with and without fentanyl after continuous epidural infusion in children: A multicenter trial","volume":"99","author":"Lerman","year":"2003","journal-title":"Anesthesiology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1441","DOI":"10.1093\/bja\/59.11.1441","article-title":"Continuous extradural anaesthesia in children. 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D\u2019Anesthesie"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e544","DOI":"10.1097\/BPO.0000000000002108","article-title":"Mode of Anesthesia and Bladder Management Following Orthopaedic Surgery in Children with Cerebral Palsy: A System Level Analysis","volume":"42","author":"Buckon","year":"2022","journal-title":"J. Pediatric Orthop."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1156","DOI":"10.1007\/BF03012456","article-title":"Epidural analgesia in children with cerebral palsy","volume":"45","author":"Brenn","year":"1998","journal-title":"Can. J. Anaesth. J. Can. D\u2019Anesthesie"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1001\/archsurg.143.6.551","article-title":"Indwelling urinary catheter use in the postoperative period: Analysis of the national surgical infection prevention project data","volume":"143","author":"Wald","year":"2008","journal-title":"Arch. Surg."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1016\/j.ijsu.2015.03.003","article-title":"Early postoperative removal of urethral catheter in patients undergoing colorectal surgery with epidural analgesia-a prospective pilot clinical study","volume":"16","author":"Coyle","year":"2015","journal-title":"Int. J. Surg."}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/9\/9\/1316\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:19:41Z","timestamp":1760141981000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/9\/9\/1316"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,29]]},"references-count":16,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2022,9]]}},"alternative-id":["children9091316"],"URL":"https:\/\/doi.org\/10.3390\/children9091316","relation":{},"ISSN":["2227-9067"],"issn-type":[{"value":"2227-9067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8,29]]}}}