Abstract
Purpose
Inguinal hernia repair is a common general surgery procedure with low morbidity. However, postoperative urinary retention (PUR) occurs in up to 22% of patients, resulting in further extraneous treatments.This single institution series investigates whether patient comorbidities, surgical approaches, and anesthesia methods are associated with developing PUR after inguinal hernia repairs.
Methods
This is a single institution retrospective review of inguinal hernia from 2012 to 2015. PUR was defined as patients without a postoperative urinary catheter who subsequently required bladder decompression due to an inability to void. Univariate and multivariate logistic regressions were performed to quantify the associations between patient, surgical, and anesthetic factors with PUR. Stratification analysis was conducted at age of 50 years.
Results
445 patients were included (42.9% laparoscopic and 57.1% open). Overall rate of PUR was 11.2% (12% laparoscopic, 10.6% open, and p = 0.64). In univariate analysis, PUR was significantly associated with patient age >50 and history of benign prostatic hyperplasia (BPH). Risk stratification for age >50 revealed in this cohort a 2.49 times increased PUR risk with lack of intraoperative bladder decompression (p = 0.013).
Conclusions
At our institution, we found that patient age, history of BPH, and bilateral repair were associated with PUR after inguinal hernia repair. No association was found with PUR and laparoscopic vs open approach. Older males may be at higher risk without intraoperative bladder decompression, and therefore, catheter placement should be considered in this population, regardless of surgical approach.
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AB declares no conflict of interest. AD declares no conflict of interest. AM declares no conflict of interest. HL declares no conflict of interest. XH declares no conflict of interest. CW declares no conflict of interest. JO declares no conflict of interest. HN declares no conflict of interest.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional review board (IRB)and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required as per IRB.
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This is an IRB-approved study, whereby permission was given to review patient information.
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Patients who undergo treatment at our institution initially signed a consent form allowing us to study their clinical outcomes.
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Blair, A.B., Dwarakanath, A., Mehta, A. et al. Postoperative urinary retention after inguinal hernia repair: a single institution experience. Hernia 21, 895–900 (2017). https://doi.org/10.1007/s10029-017-1661-4
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DOI: https://doi.org/10.1007/s10029-017-1661-4