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Risk Factors for Postoperative Urinary Retention After Endoscopic Hernia Repair: Age and Unilateral Operation make the Difference

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Abstract

Background

Postoperative urinary retention (POUR) is a common complication after inguinal hernia repair that may result in catheter-related infections or injuries, longer hospital stays, and thus, higher overall costs. Our aim was to assess the incidence of POUR after endoscopic total extraperitoneal (TEP) inguinal hernia repair and identify its risk factors.

Methods

We retrospectively analyzed all data that were included in a prospective Hernia Database for patients undergoing a TEP inguinal hernia repair at our institution between July 2012 and May 2018. POUR was defined as the inability to urinate spontaneously after surgery, thus requiring a bladder catheter.

Results

Data from 1570 patients were included. Sixty-five patients developed POUR, which was an incidence of 4.1%. In the univariate analysis, patients over 50 years of age (1.6% vs. 5.5%), patients with higher American Society of Anesthesiologists (ASA) score (ASA-1 2.7% vs. ASA-3 12.5%), previous prostate surgery (3.9% vs. 10.9%), unilateral operation (1.9% vs. 6.0%), and intraoperative drain placement (2.1% vs. 4.9%) developed POUR more often than younger patients. After multivariate adjustment, advanced age and unilateral surgery remained risk factors for POUR.

Conclusion

Advanced age and unilateral inguinal hernia repair, possibly due to a lack of catheterization, were risk factors for POUR. Due to increasing outpatient inguinal hernia repairs worldwide, it is imperative to identify patients who are at risk of POUR to apply prophylactic measures and reduce readmission, and thus, reduce health-care costs.

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Abbreviations

ASA:

American Society of Anesthesiologists

BMI:

Body mass index

POUR:

Postoperative urinary retention

TEP:

Total extraperitoneal

IQR:

Interquartile range

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Funding

No funding or financial support was provided for the study.

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Authors and Affiliations

  1. Department of Surgery, Cantonal Hospital of Baden, Im Ergel 1, 5404, Baden, Switzerland

    S. Di Natale, J. Slieker, S. Soppe, U. Bieri, A. Keerl & A. Nocito

Authors
  1. S. Di Natale
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  2. J. Slieker
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  3. S. Soppe
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  4. U. Bieri
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  5. A. Keerl
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  6. A. Nocito
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Corresponding author

Correspondence to A. Nocito.

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Conflicts of interest

All the authors of this manuscript declare no conflicts of interest.

Data availability

HerniaMed Registry.

Ethical Approval

11.11.2019, Project-ID 2019-01298, Ethikkommission Nordwest- und Zentralschweiz (EKNZ).

Consent for publication

Patients provided written informed consent for documentation of their anonymized patient data in the HerniaMed Registry GmbH i.G.

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This study was presented at the 41st Annual European Hernia Society Congress at Hamburg, Germany, on 13 September 2019.

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Di Natale, S., Slieker, J., Soppe, S. et al. Risk Factors for Postoperative Urinary Retention After Endoscopic Hernia Repair: Age and Unilateral Operation make the Difference. World J Surg 45, 3616–3622 (2021). https://doi.org/10.1007/s00268-021-06292-0

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  • DOI: https://doi.org/10.1007/s00268-021-06292-0

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