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Postoperative urinary retention after laparoscopic total extraperitoneal inguinal hernia repair. J Surg Res 2018 Nov;231:309-315

Date

10/04/2018

Pubmed ID

30278946

DOI

10.1016/j.jss.2018.05.052

Scopus ID

2-s2.0-85049020303 (requires institutional sign-in at Scopus site)   17 Citations

Abstract

BACKGROUND: Postoperative urinary retention (POUR) after laparoscopic inguinal hernia repair has an incidence of 2%-30%. POUR can lead to increased length of stay, decreased patient satisfaction, and increased health-care costs. The objective of this study was to determine the patient risk factors at our institution contributing to POUR after laparoscopic total extraperitoneal (TEP) inguinal hernia repair.

METHODS: A retrospective chart review of patients who underwent a laparoscopic TEP inguinal hernia repair at our institution from 2009 to 2016. POUR is defined as the inability to urinate requiring urinary straight or indwelling catheterization in the postoperative period. Univariate analyses were performed on perioperative variables and their correlation with POUR.

RESULTS: In total, 578 laparoscopic TEP inguinal hernia repair patients were included in the study: 277 (48%) indirect, 144 (25%) direct, 6 (1%) femoral, and 151 (26%) combination of direct, indirect, and/or femoral hernias. Of these, 292 (51%) were bilateral, and 286 (49%) were unilateral. Overall, 64 (11.1%) of the 578 patients developed POUR. POUR was significantly associated with benign prostatic hyperplasia, age 60 y or older, urinary tract infection within 30 d, and decreased body mass index.

CONCLUSIONS: Patients aged greater than 60 y, with benign prostatic hyperplasia, and a decreased body mass index (≤25.8 kg/m2) were more likely to develop POUR after laparoscopic TEP inguinal hernia repair. In addition, these patients were more likely to develop a urinary tract infection within 30 d. Future quality initiatives can be explored to minimize the incidence of POUR in high-risk patient populations.

Author List

Roadman D, Helm M, Goldblatt MI, Kastenmeier A, Kindel TL, Gould JC, Higgins RM

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
Rana Higgins MD Associate 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
Tammy Lyn Kindel MD, PhD Associate Professor in the Surgery department at Medical College of Wisconsin




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

Adult
Aged
Aged, 80 and over
Female
Hernia, Inguinal
Herniorrhaphy
Humans
Laparoscopy
Male
Middle Aged
Postoperative Complications
Retrospective Studies
Risk Factors
Urinary Retention