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Voiding After Neuraxial Day Case — FRCA Final MCQ

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ModerateDay SurgeryVoiding After Neuraxial Day CaseFRCA Final

A 50-year-old man (ASA II) is recovering from a laparoscopic cholecystectomy performed as a day case. He meets all standard discharge criteria except he has not passed urine. He had a spinal anaesthetic with 2 mL 0.5% heavy bupivacaine. Is voiding a mandatory discharge criterion?

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Correct answer: A — Yes – but only after neuraxial anaesthesia

Post-operative urinary retention is a recognised complication of neuraxial (spinal and epidural) anaesthesia due to blockade of the sacral parasympathetic nerves (S2-S4) that control the detrusor muscle. BADS and RCOA guidelines recommend that patients who have received neuraxial blockade should demonstrate the ability to void before discharge. For patients who have had only general anaesthesia without neuraxial techniques and without risk factors for retention (BPH, pelvic surgery), voiding is not a mandatory discharge requirement.

Reference: BADS – 2019 – Discharge criteria; RCOA – 2023 – Day surgery module