We are having a big push to not use catheters in their pts from a number of ortho surgeons. While this is, in my opinion, inifinitely safer in terms of infection reduction and provides motivation to pts to get out of bed w after surgery or face using the pan, we inevitably have the older gentlemen who just cannot seem to pee within 6-8 hours after surgery and wind up with bladder scans of 450+, get straight cathed or have a foley placed for 24 hours.
I just had lunch with a friend who had knee surgery, male, 60+ yrs old, who said no catheter and he was prescribed Flomax (tamsulosin) for three days post surgery when the opioid pain medications would be most highly used, and no problems peeing.
Anybody else seen this push for no catheters and/or the use of the med? I read more on the drug literature and could see possible blood pressure problems if a pt is volume depleted post surgery, but maybe this has merit as the drug actually has effect on the smooth muscle of the the bladder sphincter?