User:Wikimasterking/sandbox

Notes for your content and suggested changes
Age: Older people may suffer from degeneration of neural pathways involved with bladder function and it can lead to an increased risk of postoperative urinary retention.

Medications: Anticholinergics, medications with anticholinergic properties, alpha-adrenergic agonists, opiates, nonsteroidal antiinflammatories (NSAIDs), calcium-channel blockers and beta-adrenergic agonists, may increase the risk of postoperative urinary retention.

Anesthesia: General anesthetics may cause bladder atony by acting as a smooth muscle relaxant. General anesthesics can directly interfere with autonomic regulation of detrusor tone and predispose people to bladder overdistention and subsequent retention. Spinal anesthesia results in a blockade of the micturition reflex. Spinal anesthesia shows a higher risk of postoperative urinary retention compared to general anesthesia.

Benign prostatic hyperplasia: Men with benign prostatic hyperplasia are at an increased risk of acute urinary retention.

Surgery related: Operative times longer than 2 hours may lead to an increased risk of postoperative urinary retention 3-fold.

''Thanks for taking the time to re-visit this edit. I know that it takes time to adjust from an academic style of writing to Wikipedia. You have done a nice job collecting this information. I have made some modifications and edits, please work from the above version. You can edit the above text directly. Here are a few comments:'' JenOttawa (talk) 02:52, 27 November 2017 (UTC)
 * I removed "patients" and replaced with "people" (Wikipedia prefers this, as mentioned in your comments above).
 * Can you try to add wiki links to terms? You will need quite a few. Please be sure that they are not already linked earlier in the article subheading.
 * I find a few of your sentences to be a little complex for Wikipedia.
 * It is not necessary to state the # of studies in the meta-analysis, unless it is a controversial topic and you are presenting different viewpoints. I removed this sentence.
 * Please note: be sure to review the Wikistyle guide for medical articles (WP:MEDMOS. This content should not be added as a new heading to the article, it would go under the "causes" section. I would suggest putting it under the "chronic" paragraph. Please make sure that your new heading matches the style (size) of the "chronic" heading.
 * I feel that you do not need separate headings for all these risk factors. I have put the sub-headings on the same line for now.
 * I removed "sex" as a risk factor, as this did not seem clear to me. If you to try to re-word it in the context of benign prostatic hyperplasia, or stating if males or females have a higher/lower risk, this may be a little more clear. I was also unsure why you added it, if you then went on to say that it "has not been strongly elucidated for postoperative urinary retention." Did you mean the mechanism of why it is a risk factor is not known? I removed it for now.

removed primary ref
Hello, I used a review article for describing postoperative urinary retention risk factors and cited that review articles as well as primary resources that review article was using. I removed primary resources and left only the review article in the references.

Add a section called “postoperative urinary retention risk factors” and add the following information:

Postoperative urinary retention risk factors: age, medications, anesthetics, benign prostatic hyperplasia/lower urinary tract symptoms, and surgery related factors, including operating room time, intravenous fluids, and procedure type.

Age:

Older patients can suffer from degeneration of neural pathways involved with bladder function and it can be responsible for the increased risk of postoperative urinary retention. The risk of postoperative urinary retention increases up to 2.11 fold for patients older than 60 years.

Sex:

Another risk factor is sex. It has been shown that sex increases risks for urinary retention not related to surgery given. For men, benign prostatic hyperplasia increases risk, due to the fact that it’s a risk factor for lower urinary tract dysfunction and retention. This association has not been as strongly elucidated for postoperative urinary retention.

Medications:

The following medications are associated with increased risks of postoperative urinary retention: anticholinergics and medications with anticholinergic properties, alpha-adrenergic agonists, opiates (The incidence of opioid precipitated retention in the postoperative setting has been found to be as high as 25%. ), nonsteroidal antiinflammatories (NSAIDs) (up to 2 fold. ), calcium-channel blockers and beta-adrenergic agonists.

Anesthesia:

General anesthetics can cause bladder atony by acting as smooth muscle relaxants. In addition to that, it can directly interfere with autonomic regulation of detrusor tone and predispose patients to bladder overdistention and subsequent retention. On the other hand, spinal anesthesia results in a blockade of the micturition reflex. Overall, spinal anesthesia shows a higher risk of postoperative urinary retention compared to general anesthesia.

Benign prostatic hyperplasia:

Men with benign prostatic hyperplasia are at an increased risk of acute urinary retention. This finding is supported by a meta-analysis of 570 articles. It was established that lower urinary tract symptoms were significantly associated with an increased risk of urinary retention (OR 2.83).

Surgery related:

Operative times longer than 2 hours increased the risk of postoperative urinary retention 3-fold. 17 Longer surgery times increase patients’ risks of urinary retention. A rule of thumb suggests that for operative cases lasting longer than 3 hours, a Foley catheter should be inserted preoperatively. Overall, there is a theory that longer operative times, increased amounts of IV fluids, and higher doses of anesthetics and opiates likely all together increase risks of postoperative urinary retention.