Advertisement

Hernia

, Volume 23, Issue 2, pp 311–315 | Cite as

Identifying patients at risk for urinary retention following inguinal herniorrhaphy: a single institution study

  • B. R. Hall
  • P. R. Armijo
  • B. Grams
  • D. Lomelin
  • D. OleynikovEmail author
Original Article

Abstract

Purpose

We aim to identify patients at risk for post-operative urinary retention (POUR) and factors associated with POUR.

Methods

Males who underwent inguinal hernia repair (IHR) from June 2010 to September 2014 at a single institution were grouped according to the presence (symptomatic) or absence (asymptomatic) of preoperative urogenital symptoms (UGS). Patients ≤ 18 years of age were excluded. POUR was defined as the need to catheterize a patient who had not voided 6 h after surgery. Data were examined using IBM SPSS v23.0.

Results

Of the 60 asymptomatic and 30 symptomatic patients identified, no differences were seen in age (55 vs. 65, p = 0.13), length of stay > 1 day (3% vs. 13%, p = 0.09), bilateral inguinal herniation (23% vs. 23%, p = 1.00), or laparoscopic approach (70% vs. 69%, p = 1.00); however, significant differences were seen in POUR (5% vs. 27%, p = 0.01) and α-blocker utilization (50% vs. 80%, p = 0.01). When age-matched, neither POUR (10% vs. 27%, p = 0.10) or α-blocker utilization (57% vs. 80%, p = 0.05) significantly differed between asymptomatic and symptomatic patients, respectively. Logistic regression analysis demonstrated that only bilateral inguinal herniation (OR 6.55, p = 0.03) and symptoms (OR 6.78, p = 0.02) were associated with POUR. Asymptomatic patients with a unilateral hernia have a 4.3% risk of POUR, whereas symptomatic patients with a bilateral inguinal hernia have at 57.1% risk.

Conclusions

We demonstrate that bilateral inguinal herniation and UGS independently increase the risk of POUR, whereas α-blockers do not. For the general surgical population, α-blockers should not be routinely prescribed to all patients and instead should be limited to high-risk patients.

Keywords

Urinary retention Inguinal hernia Surgery Alpha-blocker 

Notes

Acknowledgements

Funding for this study was provided by the Center for Advanced Surgical Technology at the University of Nebraska Medical Center. BRH was responsible for writing of the manuscript with the assistance of PRA who is also responsible for all statistical analyses. BG was responsible for data collection and clinical input. DL was responsible for initial data collection and preliminary analysis. DO was responsible for oversight of the project, clinical input, and takes responsibility for article submission.

Compliance with ethical standards

Conflict of interest

Authors BH, PRA, BG, and DL declare no conflict of interest. DO is a shareholder in Virtual Incision Corporation, and received Research Grant not related to the submitted work from Medtronic and Gore.

Ethical approval

All study procedures for this single-center retrospective study were reviewed and approved by the UNMC Institutional Review Board.

Human and animal rights

This study including human participants has been performed in accordance with the ethical standards of the Declaration of Helsinki and its later amendments.

Informed consent

A waiver for patient written informed consent was obtained for this study.

References

  1. 1.
    Hall MJ, Schwartzman A, Zhang J, Liu X (2017) Ambulatory surgery data from hospitals and ambulatory surgery centers: United States, 2010. Natl Health Stat Rep 102:1–5Google Scholar
  2. 2.
    Patel JA, Kaufman AS, Howard RS, Rodriguez CJ, Jessie EM (2015) Risk factors for urinary retention after laparoscopic inguinal hernia repairs. Surg Endosc 29(11):3140–3145.  https://doi.org/10.1007/s00464-014-4039-z CrossRefGoogle Scholar
  3. 3.
    Koch CA, Grinberg GG, Farley DR (2006) Incidence and risk factors for urinary retention after endoscopic hernia repair. Am J Surg 191(3):381–385.  https://doi.org/10.1016/j.amjsurg.2005.10.042 CrossRefGoogle Scholar
  4. 4.
    Woo HH, Carmalt HL (1995) A placebo controlled double blind study using perioperative prazosin in the prevention of urinary retention following inguinal hernia repair. Int Urol Nephrol 27(5):557–562.  https://doi.org/10.1097/00005392-199803000-00179 CrossRefGoogle Scholar
  5. 5.
    Sivasankaran MV, Pham T, Divino CM (2014) Incidence and risk factors for urinary retention following laparoscopic inguinal hernia repair. Am J Surg 207(2):288–292.  https://doi.org/10.1016/j.amjsurg.2013.06.005 CrossRefGoogle Scholar
  6. 6.
    Mohammadi-Fallah M, Hamedanchi S, Tayyebi-Azar A (2012) Preventive effect of tamsulosin on postoperative urinary retention. Korean J Urol 53(6):419–423.  https://doi.org/10.4111/kju.2012.53.6.419 CrossRefGoogle Scholar
  7. 7.
    Mason SE, Scott AJ, Mayer E, Purkayastha S (2016) Patient-related risk factors for urinary retention following ambulatory general surgery: a systematic review and meta-analysis. Am J Surg 211(6):1126–1134.  https://doi.org/10.1016/j.amjsurg.2015.04.021 CrossRefGoogle Scholar
  8. 8.
    Shaw M, Pahari H (2014) The role of peri-operative use of α-blocker in preventing lower urinary tract symptoms in high risk patients of urinary retention undergoing inguinal hernia repair in males above 50 years. J Indian Med Assoc 112:13–14Google Scholar
  9. 9.
    Blair AB, Dwarakanath A, Mehta A et al (2017) Postoperative urinary retention after inguinal hernia repair: a single institution experience. Hernia 21(6):895–900.  https://doi.org/10.1007/s10029-017-1661-4 CrossRefGoogle Scholar
  10. 10.
    Goldman G, Leviav A, Mazor A et al (1988) α-adrenergic blocker for posthernioplasty urinary retention: prevention and treatment. Arch Surg 123(1):35–36.  https://doi.org/10.1001/archsurg.1988.01400250037005 CrossRefGoogle Scholar
  11. 11.
    Gonullu NN, Dulger M, Utkan NZ, Canturk NZ, Alponat A (1999) Prevention of postherniorrhaphy urinary retention with prazosin. Am Surg 65(1):55Google Scholar

Copyright information

© Springer-Verlag France SAS, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of SurgeryUniversity of Nebraska Medical Center, 986245 Nebraska Medical CenterOmahaUSA
  2. 2.Center for Advanced Surgical TechnologyUniversity of Nebraska Medical Center, 986246 Nebraska Medical CenterOmahaUSA
  3. 3.College of MedicineUniversity of Nebraska Medical Center, 986245, Nebraska Medical CenterOmahaUSA

Personalised recommendations