Urinary retention following elective inguinal herniorrhaphy - Tips From Other Journals

Date: August, 1991

The incidence of urinary retention after general surgical procedures has ranged from 7 percent to 52 percent. Urinary retention is a common complication of inguinal hernia repair, but contributing b factors have not been identified. To clarify these factors, Petros and colleagues retrospectively studied patients who underwent elective inguinal herniorrhaphy.

The study included 295 male patients who underwent herniorrhaphy between 1986 and 1989. Patients with a history of urinary retention, previous transurethral surgery, prostatic hypertrophy or use of medications associated with urinary retention were excluded from the study. Surgery was performed after the administration of either a general anesthetic (halothane) or a short-acting spinal anesthetic (5 percent lidocaine). Catheterization was performed only when the bladder was palpable or the patient was uncomfortable.

Urinary retention occurred in 41 (14 percent) of the patients. The type of hernia (direct or indirect) and the side of the body in which it was located were not associated with urinary retention.

Retention was significantly more common in patients 53 years of age or older than in younger patients. Use of general anesthetic was also associated with a significantly increased incidence of retention. This risk persisted after controlling for age. The volume of intravenous fluid received in the perioperative period was also associated with urinary retention. Patients who received more than 1,200 mL of fluid had a significantly increased risk of retention, although this association diminished after controlling for age and type of anesthesia used.

The authors suggest that urinary retention after hemiorrhaphy may be prevented by limiting the amount of fluid given perioperatively and using a spinal anesthetic rather than a general anesthetic, particularly in older patients. (American Journal of Surgery, April 1991, vol. 161, p. 431.) N

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