Thoracic epidural analgesia: What about the urinary bladder?

SummaryThe impact of thoracic epidural analgesia (TEA) on lower urinary tract function, although a common observation in everyday clinical practice, has not been examined in depth. One factor often observed in patients with TEA is postoperative urinary retention (POUR). POUR is linked to several factors including age, gender, postoperative pain, type of surgical procedure, use of opioids and neuraxial anaesthesia/analgesia. Its inadequate management can lead to urinary tract infections and/or bladder overdistension with long term debilitating morbidities and associated high costs. This paper discusses the effects and potential modulatory mechanisms of the TEA on lower urinary tract function.