Identifying patients at risk for urinary retention following inguinal herniorrhaphy: a single institution study

B. R. Hall, P. R. Armijo, B. Grams, D. Lomelin, Dmitry Oleynikov

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)311-315
Number of pages5
JournalHernia
Volume23
Issue number2
DOIs
StatePublished - Apr 1 2019

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Urinary Retention
Groin
Herniorrhaphy
Inguinal Hernia
Hernia
Length of Stay
Logistic Models
Regression Analysis

Keywords

  • Alpha-blocker
  • Inguinal hernia
  • Surgery
  • Urinary retention

ASJC Scopus subject areas

  • Surgery

Cite this

Identifying patients at risk for urinary retention following inguinal herniorrhaphy : a single institution study. / Hall, B. R.; Armijo, P. R.; Grams, B.; Lomelin, D.; Oleynikov, Dmitry.

In: Hernia, Vol. 23, No. 2, 01.04.2019, p. 311-315.

Research output: Contribution to journalArticle

Hall, B. R. ; Armijo, P. R. ; Grams, B. ; Lomelin, D. ; Oleynikov, Dmitry. / Identifying patients at risk for urinary retention following inguinal herniorrhaphy : a single institution study. In: Hernia. 2019 ; Vol. 23, No. 2. pp. 311-315.
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abstract = "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.",
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