We conducted a retrospective study of 104 patients to examine the efficacy of two methods of urinary bladder management after total hip arthroplasty under spinal anesthesia. Patients who had total hip replacement was randomly assigned either to Group I, in which indwelling catheters were placed during the operation and removed the next morning, or Group II, in which urinary retention was managed by intermittent catheterization as needed. After the removal of the indwelling catheter, the patients in Group I had a lower incidence of urinary retention than those in Group II. Bladder distention(volume above 700ml) was more common in Group II and was associated with an increased need for subsequent long-term catheterization. There was no significant difference between the groups in the rates of urinary tract infection. We conclude that the short-term use of an indwelling catheter after extended surgery, such as joint replacement, reduces the incidence of urinary retention and bladder overdistention, without increasing the rate of urinary tract infection.