Faculty Collaboration Database

Surgery duration predicts urinary retention after inguinal herniorrhaphy: a single institution review. Surg Endosc 2015 Nov;29(11):3246-50

Date

01/24/2015

Pubmed ID

25612548

Pubmed Central ID

PMC4747332

DOI

10.1007/s00464-015-4068-2

Scopus ID

2-s2.0-84944357812 (requires institutional sign-in at Scopus site)   28 Citations

Abstract

BACKGROUND: Inguinal hernia repair, laparoscopic or open, is one of the most frequently performed operations in general surgery. Postoperative urinary retention (POUR) can occur in 0.2-35 % of patients after inguinal hernia repair. The primary objective of this study was to determine the incidence of POUR after inguinal hernia repair. As a secondary goal, we sought to determine whether perioperative and patient factors predicted urinary retention.

METHODS: This study is a retrospective review of patients who underwent inguinal hernia repair with synthetic mesh at the Medical College of Wisconsin from January 2007 to June 2012. Procedures were performed by four surgeons. Clinical information and perioperative outcomes were collected up to hospital discharge. Urinary retention was defined as need for urinary catheterization postoperatively.

RESULTS: A total of 192 patients were included in the study (88 bilateral, 46 %) and (104 unilateral, 54 %). The majority of subjects (76 %) underwent laparoscopic repair. The overall POUR rate was 13 %, with 25 of 192 patients requiring a Foley catheter prior to discharge. POUR was significantly associated with bilateral hernia repairs (p = 0.04), BMI ≥ 35 kg/m(2) (p = 0.05) and longer operative times (p = 0.03). Based on odds ratio (OR) estimates, for every 10-min increase in operative time, an 11 % increase in the odds of urinary retention is expected (OR 1.11, CI 1.004-1.223; p = 0.04). For every 10-min increase in operative time, an 11 % increase in POUR is expected.

CONCLUSIONS: Bilateral hernia repairs, BMI ≥ 35 kg/m(2), and operative time are significant predictors of POUR. These factors are important to determine potential risk to patients and interventions such as strict fluid administration, use of catheters, and potential premedication.

Author List

Hudak KE, Frelich MJ, Rettenmaier CR, Xiang Q, Wallace JR, Kastenmeier AS, Gould JC, Goldblatt MI

Authors

Matthew I. Goldblatt MD Professor in the Surgery department at Medical College of Wisconsin
Jon Gould MD Chief, Professor in the Surgery department at Medical College of Wisconsin
Andrew Sean Kastenmeier MD Associate Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Adult
Aged
Aged, 80 and over
Female
Hernia, Inguinal
Herniorrhaphy
Humans
Incidence
Laparoscopy
Male
Middle Aged
Operative Time
Postoperative Complications
Prognosis
Retrospective Studies
Urinary Retention
Wisconsin
Young Adult