Acute urinary tract complications following general surgical procedures.

The most frequent postoperative urinary problem after various types of general operations is urinary retention. It may be due to previously unrecognized dynamic obstruction, but is more often psychogenic or due to a temporary disturbance in function of the sympathetic and parasympathetic nervous systems. Catheterization may be done safely as a means of preventing over-distention of the bladder. Irritative postoperative lesions are usually due to trigonitis, cystitis or pyelitis. The immediate trauma of pelvic operation is sometimes followed by infection. Careful study will reveal the cause and the type of infection and will give an indication for proper treatment. Anuria may be the result of postoperative shock, chemical injury of the kidneys or block of the urinary channels by crystals, detritus, edema, or operative accident. A careful, immediate analysis of the problem is imperative. Fluid intake in anuria must not be pushed to the point of edema. Accidental surgical blocking or severance of a ureter usually may be repaired without difficulty following a period of recovery to permit subsidence of the acute tissue reaction caused by urinary extravasation.