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Urinary retention following total hip and knee arthroplasty is a common problem, frequently requiring catheterisation in the immediate post-operative period. The direct relationship between urinary tract instrumentation and deep sepsis in total hip replacements is well documented. This prospective study analysed 164 male patients who underwent primary arthroplasty between September 2004 and March 2005 inclusive. Upon admission and prior to surgery, all patients answered an eight-point urinary symptom questionnaire and were tested on their ability to micturate while supine. Thirty-three patients required urinary catheterisation, 131 did not. The mean age of the catheterised group was 71.4 years and the non-catheterised group was 63.6 years ( P<0.001). There was no difference in blood loss between the two groups. With regards to the symptom questionnaire, the mean score in the catheter group was 4.1 and the non-catheter group was 1.8 ( P<0.001). The ability to micturate in a supine position was of no predictive value with 23 patients in the catheter group able to do so. These results show the value of a urinary symptom questionnaire used pre-operatively in predicting those who may require post-operative urinary catheterisation. By appropriate use of this tool, patients with potential for post-operative retention may be identified before surgery. [ABSTRACT FROM AUTHOR]