101 - Freie Mitteilung
Bariatry & hernia II
17. Mai 2019, 14:15 - 15:45, Bellavista 5, 6. OG
Postoperative urinary retention after endoscopic total extraperitoneal inguinal hernia repair: A retrospective analysis in a single centre
S. Di Natale, J. Slieker, S. Soppe, U. Bieri, A. Keerl, A. Nocito, Presenter: S. Di Natale (Baden)
Postoperative urinary retention (POUR) is a common complication after inguinal hernia repair with a reported incidence up to 20%. POUR may cause catheter-related infections or injuries, longer hospital stay and higher overall costs. Our primary aim was to assess the incidence of POUR after endoscopic total extraperitoneal (TEP) inguinal hernia repair at our institution, and identify risk factors.
We retrospectively analysed all patients included in a prospective Hernia Database who underwent a TEP inguinal hernia repair at our institution between July 2012 and May 2018. POUR was defined as the inability to urinate spontaneously after surgery requiring a bladder catheter. A univariate analysis was performed to identify risk factors of POUR.
In total 1570 patients were included in the study. 65 patients developed POUR, corresponding to an incidence of 4.1%. Patients who developed POUR were significantly older (56 years vs. 71 years, p-value <0.001), and had a higher American Society of Anesthesiologists (ASA) score (ASA-3 6% vs 20%, p-value <0.001). Incidence of POUR was significantly increased in patients who previously underwent prostate surgery (3.9% vs 10.9%, p-value 0.020), patients undergoing a unilateral operation (1.9% vs 6.0%, p-value <0.001), and patients who received an intraoperative drainage (2.1% vs 4.9%, p-value 0.001). Gender, body mass index, preoperative pain, emergency operation, operation time, or fixation-technique did not influence the risk of developing POUR. In patients who developed POUR the length of stay more often exceeded our standard 2 postoperative days (14.2% non-POUR vs 35.4% POUR, p-value <0.001). Postoperative pain was not increased in patients with POUR.
Several high-risk patient categories were identified, and multivariate analysis and further prospective analysis based on high-risk patients are being performed. The influence of an intraoperative bladder catheter, which at our institute is often omitted for unilateral surgery, has to be investigated. Considering current efforts in Switzerland to increase outpatient inguinal hernia operations, the identification of high-risk patients of POUR is particularly important.