Courtney L Devin, MD, Guillaume S Chevrollier, MD, Richard Zheng, MD, Samantha L Savitch, BA, Michael J Pucci, MD, Karen A Chojnacki, MD, Ernest L Rosato, MD, Adam C Berger, MD, Francesco Palazzo, MD. Thomas Jefferson University
INTRODUCTION: Urinary retention (UR) is common after laparoscopic inguinal hernia repair (LIHR), with reported incidence ranging from 2-30%. We sought to determine the incidence of postoperative UR at our institution and identify risk factors for its development.
METHODS AND PROCEDURES: A retrospective chart review of all patients undergoing LIHR from March 2014 to March 2017 was performed. Postoperative UR was defined as the inability to void requiring urethral catheterization prior to discharge or return to the emergency department requiring catheterization. Demographics and perioperative factors were compared between patients with and without UR using Fisher’s exact tests and student’s t-tests. Univariate analysis was conducted by logistic regression analysis and odds ratios (OR) were calculated to identify risk factors for UR. All statistical analysis was performed with Stata v13.0 and significance was set at p<0.05.
RESULTS: Of the 354 patients who underwent laparoscopic inguinal hernia repair, 23 patients (6.7%) experienced postoperative urinary retention. Patients who developed urinary retention were significantly older (53 vs 65, p<0.001). Other comparisons between groups are presented in the Table. On univariate analysis, we found the following factors to be significant: age > 65 years (OR-1.1, p=0.001), securing mesh with tacker (OR-4.8, p=0.001), peritoneal violation (OR-3.5, p=0.008), amount of intraoperative intravenous fluids (OR-1.0, p=0.009), history of benign prostatic hyperplasia (OR-5.3, p=0.002), diabetes (OR-5.2, p=0.014), and prior IHR (OR-3.5, p=0.008). Midazolam (OR-4.3, p=0.005) and Propofol (OR-5.2, p=0.009) use were also significant factors for UR.
CONCLUSIONS: Postoperative urinary retention after LIHR is likely multifactorial. In this study, patient characteristics, surgical technique, perioperative medications, and fluids administered appeared to be linked with higher rates of postoperative UR. Larger studies are needed to assess these as independent risk factors for UR after LIHR. These results can inform the preoperative counseling and the development of strategies to mitigate UR after LIHR.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 95259
Program Number: P532
Presentation Session: Poster Session (Non CME)
Presentation Type: Poster