D. F. Roadman1, M. Helm1, M. Goldblatt1, A. Kastenmeier1, T. Kindel1, J. Gould1, R. Higgins1 1Medical College Of Wisconsin,Milwaukee, WI, USA
Introduction: Post-operative urinary retention (POUR) after laparoscopic inguinal hernia repair has an incidence of 2-30%. POUR can lead to urinary tract infections, longer lengths of stay, and decreased patient satisfaction. The primary objective of this study was to determine the incidence of and perioperative factors contributing to POUR at our institution in patients who underwent a laparoscopic total extraperitoneal (TEP) inguinal hernia repair.
Methods: A retrospective chart review was performed of patients who underwent a laparoscopic TEP inguinal hernia repair at our institution from 2009 to 2016. POUR was defined as patients who required indwelling or straight urinary catheterization postoperatively due to an inability to void spontaneously. Univariate analyses were performed on perioperative variables and their correlation with POUR.
Results: In total, 578 laparoscopic TEP inguinal hernia repair patients were included in the study: 277 (48%) indirect, 144 (25%) direct, 6 (1%) femoral, and 151 (26%) combination of direct, indirect and/or femoral hernias. Of these, 292 (51%) were bilateral and 286 (49%) were unilateral. Overall, 64 (11.1%) of the 578 patients developed POUR, requiring urinary catherization post-operatively. POUR was significantly associated with benign prostatic hyperplasia (BPH), age 60 years or older, urinary tract infection (UTI) within 30 days, and lower body mass index (BMI) (Table 1). Additional pre-operative, intra-operative, and post-operative variables that were not statistically significant determinants of POUR are also listed in Table 1.
Conclusion: Patients greater than 60 years old, with BPH, and a lower BMI were more likely to develop POUR after laparoscopic TEP inguinal hernia repair. Additionally, these patients were also more likely to develop a UTI within 30 days. Identifying patients at higher risk for the development of POUR can help with patient education and expectations. Additionally, future quality initiatives can be explored to minimize the incidence of POUR in high risk patient populations.
