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Effect of neuromuscular blockade reversal on post-operative urinary retention following inguinal herniorrhaphy

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Abstract

Purpose

This study aims to define the risk of post-operative urinary retention (POUR) following inguinal hernia repair in those that received sugammadex compared to anticholinesterase.

Methods

Adults undergoing inguinal herniorrhaphy from January 2019 to July 2022 with at least 30-day follow-up receiving rocuronium or edrophonium and reversed with an anticholinesterase or sugammadex were included. 1-to-2 propensity score matched models were fitted to evaluate the treatment of effect of sugammadex vs. anticholinesterase on POUR, adjusting for patient comorbidities, ASA class, wound class, operative laterality, urgency of case, and open versus minimally invasive repair.

Results

3345 patients were included in this study with 1101 (32.9%) receiving sugammadex for neuromuscular blockade reversal. The 30-day rate of POUR was 2.8%; 1.4% in the sugammadex and 4.4% in the anticholinesterase group. After propensity score matching, patients receiving sugammadex had significantly lower risk of POUR compared to anticholinesterase overall (OR 0.340, p < 0.001, 95% CI 0.198–0.585), in open (OR 0.296, p = 0.013, 95% CI 0.113–0.775) and minimally invasive cases (OR 0.36, p = 0.002, 95% CI 0.188–0.693), unilateral (OR 0.371, p = 0.001, 95% CI 0.203–0.681) and bilateral repairs (OR 0.25, p = 0.025, 95% CI 0.074–0.838), elective (OR 0.329, p < 0.001, 95% CI 0.185–0.584) and clean cases (OR 0.312, p < 0.001, 95% CI 0.176–0.553).

Conclusions

The incidence of 30-day new onset POUR was 2.8%. Sugammadex was associated with significantly lower risk of POUR after inguinal herniorrhaphy compared to anticholinesterase overall and when stratifying by operative modality, laterality, and wound class.

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Authors and Affiliations

  1. Department of Surgery, Henry Ford Hospital, Detroit, MI, USA

    Lucy Ching Chau, Alexa Jarman, Rebecca Ferguson, Ryan Soheim, Kellie McFarlin & Cletus Stanton

  2. Wayne State University School of Medicine, Detroit, MI, USA

    Aaron Prater

Authors
  1. Lucy Ching Chau
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  2. Alexa Jarman
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  4. Rebecca Ferguson
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  7. Cletus Stanton
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Correspondence to Lucy Ching Chau.

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Conflict of interest

Drs. Chau, Ferguson, Jarman, Soheim, McFarlin, Stanton, and Mr. Prater have no conflicts of interest or financial ties to disclose.

Ethical approval

This study received institutional review board (IRB) approval at the Henry Ford Hospital. Given the retrospective nature of this study with minimal risk to study participant and no change to patient care is taking place, a waiver of informed consent was granted. All authors of this study declare that they have no conflict of interest.

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Informed consent was not required as this was a retrospective chart review.

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This article does not contain studies directly involving human participants as it is a database review of collected information.

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Chau, L.C., Jarman, A., Prater, A. et al. Effect of neuromuscular blockade reversal on post-operative urinary retention following inguinal herniorrhaphy. Hernia 27, 1581–1586 (2023). https://doi.org/10.1007/s10029-023-02857-1

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