Should the Routine use of Urinary Catheters be Avoided in Elective Total Joint Arthroplasty?

ABSTRACT Historically, patients undergoing general endotracheal anesthesia (GET), or spinal anesthesia for elective total joint arthroplasty (TJA) would have an indwelling urinary catheter placed which was subsequently removed the following day or the next. The purpose was to be able to monitor intake and output (I&O), as a convenience for patients in the immediate post-operative period so they wouldn\u27t have to get up in order to void, and immobility or pain issues.The patients were then at increased risk for catheter-associated urinary tract infection (CAUTI), postoperative urinary retention (POUR), delay in physical therapy (PT) mediated mobility, increased length of stay (LOS), and for the potential for a joint infection from hematogenous seeding from a urinary tract infection (UTI). Considering these risks, is it plausible to not routinely place indwelling urinary catheters in TJA patients and reserve their use for select patients with high-risk issues such as; morbid obesity, history of benign prostatic hyperplasia (BPH), prostate cancer, urogenital abnormalities, mobility or non-weight bearing issues