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Risk factors for urinary retention after laparoscopic inguinal hernia repairs

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Abstract

Background

Postoperative urinary retention (POUR) is a common entity following surgery, particularly after laparoscopic inguinal hernia repair. Here the intent is to investigate the incidence of POUR in all comers at a single institution following laparoscopic inguinal hernia repair.

Methods

A retrospective chart review of all patients who underwent laparoscopic hernia repair at our institution from January 2010 through December 2013 was performed. POUR was defined as the inability to spontaneously urinate following surgery, requiring straight catheterization or placement of a Foley catheter. Perioperative data including narcotic use, operative time, type of mesh, and intraoperative fluid use were also recorded for each patient.

Results

A total of 346 patients underwent laparoscopic inguinal hernia repair in the specified time period, 340 patients were included in this study. The incidence of POUR after laparoscopic inguinal hernia repair at our institution was 8.2 % (n = 28) with the most common presentation of POUR being failure to void (n = 23). Postoperative narcotic use of 6.5 mg or greater of morphine or morphine equivalent was associated with higher risk of POUR via ROC analysis (OR 2.5, 95 % CI 1.2–5.6, p = 0.025). In univariate analysis, age greater than 50 years was also a risk factor for developing POUR (OR 2.8, 95 % CI 1.2–6.4, p = 0.02). Factors not found to be significant included intraoperative IV fluids, history of BPH, unilateral versus bilateral repair, and preoperative void time in relation to surgery start.

Conclusions

Minimizing postoperative narcotic medications may reduce the risk of developing POUR after laparoscopic inguinal hernia repairs. If possible surgeons should consider non-steroidal anti-inflammatory drugs, acetaminophen, or regional anesthetic blocks to minimize postoperative narcotic requirements.

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References

  1. Darrah D, Griebling T, Silverstein J (2009) Postoperative urinary retention. Anesthesiol Clin 27:465–484

    Article  PubMed  Google Scholar 

  2. Jensen P, Mikkelsen T, Kehlet H (2002) Postherniorrhaphy urinary retention—effect of local, regional, and general anesthesia: a review. Reg Anesth Pain Med 27(6):621–627

    Article  Google Scholar 

  3. Koch CA, Grinberg GG, Farley DR (2006) Incidence and risk factors for urinary retention after endoscopic hernia repair. Am J Surg 191(3):381–385

    Article  PubMed  Google Scholar 

  4. McClusky D (2013) Urinary retention after laparoscopic inguinal hernia repair. In: Jacob B, Ramshaw B (eds) The SAGES manual of hernia repair. Springer Science, New York, pp 157–166

    Chapter  Google Scholar 

  5. Stallard S, Prescott S (1988) Postoperative urinary retention in general surgical patients. Br J Surg 75:1141–1143

    Article  CAS  PubMed  Google Scholar 

  6. Lau H, Patil NG, Yuen WK, Lee F (2002) Urinary retention following endoscopic totally extraperitoneal inguinal hernioplasty. Surg Endosc 16(11):1547–1550

    Article  CAS  PubMed  Google Scholar 

  7. Sivasankaran MV, Pham T, Divino CM (2014) Incidence and risk factors for urinary retention following laparoscopic inguinal hernia repair. Am J Surg 207(2):288–292

    Article  PubMed  Google Scholar 

  8. The Hopkins Opioid Conversion Program (2014) The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins. http://www.hopweb.org/

  9. Hosmer D, Lemeshow S (2000) Applied logistic regression, 2nd edn. Wiley, New York

    Book  Google Scholar 

  10. Durant PA, Yaksh TL (1988) Drug effects on urinary bladder tone during spinal morphine-induced inhibition of the micturition reflex in unanesthetized rats. Anesthesiology 68(3):325–334

    Article  CAS  PubMed  Google Scholar 

  11. Keita H, Diouf E, Tubach F, Brouwer T, Dahmani S, Mantz J, Desmonts JM (2005) Predictive factors of early postoperative urinary retention in the postanesthesia care unit. Anesth Analg 101(2):592–596

    Article  PubMed  Google Scholar 

  12. Kozol RA, Mason K, McGee K (1992) Post-herniorrhaphy urinary retention: a randomized prospective study. J Surg Res 52(2):111–112

    Article  CAS  PubMed  Google Scholar 

  13. Tammela T, Kontturi M, Lukkarinen O (1986) Postoperative urinary retention. I. Incidence and predisposing factors. Scand J Urol Nephrol 20(3):197–201

    Article  CAS  PubMed  Google Scholar 

  14. Barry MJ (2005) Textbook of benign prostatic hyperplasia, 2nd Edition. Chapter 9: Measuring and assessing BPH in population groups. Taylor & Francis, London

  15. Place R, Hyman N, Simmang C, Cataldo P, Church J, Cohen J, Denstman F, Kilkenny J, Noguera J, Orsay C, Otchy D, Rakinic J, Tjandra J (2003) Practice parameters for ambulatory anorectal surgery. Dis Colon Rectum 46(5):573–576

    Article  PubMed  Google Scholar 

  16. Doyle PT, Briscoe CE (1976) The effects of drugs and anaesthetic agents on the urinary bladder and sphincters. Br J Urol 48(5):329–335

    Article  CAS  PubMed  Google Scholar 

  17. Bodker B, Lose G (2003) Postoperative urinary retention in gynecologic patients. Int Urogynecol J Pelvic Floor Dysfunct 14(2):94–97

    Article  CAS  PubMed  Google Scholar 

  18. Wynd CA, Wallace M, Smith KM (1996) Factors influencing postoperative urinary retention following orthopaedic surgical procedures. Orthop Nurs 15(1):43–50

    Article  CAS  PubMed  Google Scholar 

  19. Joelsson-Alm E, Nyman CR, Lindholm C, Ulfvarson J, Svensen C (2009) Perioperative bladder distension: a prospective study. Scand J Urol Nephrol 43(1):58–62

    Article  PubMed  Google Scholar 

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Disclosures

Drs. Patel, Kaufman, Rodriguez, Jessie and R. Howard have no conflicts of interest or financial ties to disclose.

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Authors and Affiliations

  1. Department of General Surgery, Walter Reed National Military Medical Center, 8901 Wisconsin Avenue, Bethesda, MD, 20889-5600, USA

    Jigar A. Patel, Andrew S. Kaufman, Carlos J. Rodriguez & Elliot M. Jessie

  2. Department of Research Programs, Walter Reed National Military Medical Center, Bethesda, MD, USA

    Robin S. Howard

Authors
  1. Jigar A. Patel
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  2. Andrew S. Kaufman
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  3. Robin S. Howard
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  4. Carlos J. Rodriguez
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  5. Elliot M. Jessie
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Correspondence to Jigar A. Patel.

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Patel, J.A., Kaufman, A.S., Howard, R.S. et al. Risk factors for urinary retention after laparoscopic inguinal hernia repairs. Surg Endosc 29, 3140–3145 (2015). https://doi.org/10.1007/s00464-014-4039-z

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  • DOI: https://doi.org/10.1007/s00464-014-4039-z

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