Chronic use of oxybutynin and spinal anesthesia: a case of postoperative urinary retention and hematuria.

Male, 61 years old, 84 kg and using simvastatin in order to control hypercholesterolemia and oxybutynin to control overactive bladder. Preoperative examinations were normal. He was scheduled to varicectomy of the lower limbs on outpatient basis. Spinal anesthesia (L3/L4 interspace) with bupivacaine, 12.5 mg plus intrathecal fentanyl, 15 mcg was administered in addition to an intravenous sedation with midazolam and sufentanyl. Intravenous saline (2000 ml) and ephedrine (15 mg) was administered in order to treat hypotension during a two-hour procedure. Seven hours after the end of the procedure, the patient complained of a strong pelvic pain, dysuria, hematuria and clot elimination. He also presented a very painful urinary retention on palpation. There was an immediate symptom relief when bladder catheter was used and blood clots were seen in urine. The catheter was withdrawn and the patient was discharged on the following day, urinating with no problems but with a slight hematuria.