TY - JOUR
T1 - Identifying patients at risk for urinary retention following inguinal herniorrhaphy
T2 - a single institution study
AU - Hall, B. R.
AU - Armijo, P. R.
AU - Grams, B.
AU - Lomelin, D.
AU - Oleynikov, Dmitry
N1 - Funding Information:
Acknowledgements Funding for this study was provided by the Center for Advanced Surgical Technology at the University of Nebraska Medical Center. BRH was responsible for writing of the manuscript with the assistance of PRA who is also responsible for all statistical analyses. BG was responsible for data collection and clinical input. DL was responsible for initial data collection and preliminary analysis. DO was responsible for oversight of the project, clinical input, and takes responsibility for article submission.
Publisher Copyright:
© 2018, Springer-Verlag France SAS, part of Springer Nature.
PY - 2019/4/1
Y1 - 2019/4/1
N2 - Purpose: We aim to identify patients at risk for post-operative urinary retention (POUR) and factors associated with POUR. Methods: Males who underwent inguinal hernia repair (IHR) from June 2010 to September 2014 at a single institution were grouped according to the presence (symptomatic) or absence (asymptomatic) of preoperative urogenital symptoms (UGS). Patients ≤ 18 years of age were excluded. POUR was defined as the need to catheterize a patient who had not voided 6 h after surgery. Data were examined using IBM SPSS v23.0. Results: Of the 60 asymptomatic and 30 symptomatic patients identified, no differences were seen in age (55 vs. 65, p = 0.13), length of stay > 1 day (3% vs. 13%, p = 0.09), bilateral inguinal herniation (23% vs. 23%, p = 1.00), or laparoscopic approach (70% vs. 69%, p = 1.00); however, significant differences were seen in POUR (5% vs. 27%, p = 0.01) and α-blocker utilization (50% vs. 80%, p = 0.01). When age-matched, neither POUR (10% vs. 27%, p = 0.10) or α-blocker utilization (57% vs. 80%, p = 0.05) significantly differed between asymptomatic and symptomatic patients, respectively. Logistic regression analysis demonstrated that only bilateral inguinal herniation (OR 6.55, p = 0.03) and symptoms (OR 6.78, p = 0.02) were associated with POUR. Asymptomatic patients with a unilateral hernia have a 4.3% risk of POUR, whereas symptomatic patients with a bilateral inguinal hernia have at 57.1% risk. Conclusions: We demonstrate that bilateral inguinal herniation and UGS independently increase the risk of POUR, whereas α-blockers do not. For the general surgical population, α-blockers should not be routinely prescribed to all patients and instead should be limited to high-risk patients.
AB - Purpose: We aim to identify patients at risk for post-operative urinary retention (POUR) and factors associated with POUR. Methods: Males who underwent inguinal hernia repair (IHR) from June 2010 to September 2014 at a single institution were grouped according to the presence (symptomatic) or absence (asymptomatic) of preoperative urogenital symptoms (UGS). Patients ≤ 18 years of age were excluded. POUR was defined as the need to catheterize a patient who had not voided 6 h after surgery. Data were examined using IBM SPSS v23.0. Results: Of the 60 asymptomatic and 30 symptomatic patients identified, no differences were seen in age (55 vs. 65, p = 0.13), length of stay > 1 day (3% vs. 13%, p = 0.09), bilateral inguinal herniation (23% vs. 23%, p = 1.00), or laparoscopic approach (70% vs. 69%, p = 1.00); however, significant differences were seen in POUR (5% vs. 27%, p = 0.01) and α-blocker utilization (50% vs. 80%, p = 0.01). When age-matched, neither POUR (10% vs. 27%, p = 0.10) or α-blocker utilization (57% vs. 80%, p = 0.05) significantly differed between asymptomatic and symptomatic patients, respectively. Logistic regression analysis demonstrated that only bilateral inguinal herniation (OR 6.55, p = 0.03) and symptoms (OR 6.78, p = 0.02) were associated with POUR. Asymptomatic patients with a unilateral hernia have a 4.3% risk of POUR, whereas symptomatic patients with a bilateral inguinal hernia have at 57.1% risk. Conclusions: We demonstrate that bilateral inguinal herniation and UGS independently increase the risk of POUR, whereas α-blockers do not. For the general surgical population, α-blockers should not be routinely prescribed to all patients and instead should be limited to high-risk patients.
KW - Alpha-blocker
KW - Inguinal hernia
KW - Surgery
KW - Urinary retention
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U2 - 10.1007/s10029-018-1829-6
DO - 10.1007/s10029-018-1829-6
M3 - Article
C2 - 30255433
AN - SCOPUS:85053800287
VL - 23
SP - 311
EP - 315
JO - Hernia : the journal of hernias and abdominal wall surgery
JF - Hernia : the journal of hernias and abdominal wall surgery
SN - 1265-4906
IS - 2
ER -