Risk factors, rate of postoperative urinary retention following inguinal hernia repair

Editor's Note

A global study led by researchers at the Royal College of Surgeons in Dublin, Ireland, finds older male patients are at greater risk of developing postoperative urinary retention (POUR) following elective inguinal hernia repair.

The cohort study included 4,151 patients (3882 male and 269 female) recruited between March 1 and October 31, 2021, across 32 countries undergoing open (82.2%) and minimally invasive (17.8%) inguinal hernia repair, with a goal to “ascertain the incidence of, explore risk factors for, and determine the health service outcomes” of POUR following the procedure.

POUR occurred in 5.8% of male patients, 2.97% of female patients, and 9.5% of male patients aged 65 or older, suggesting that 1 in 17 male patients, 1 in 11 male patients aged 65 or older, and 1 in 34 female patients may develop POUR following an inguinal hernia repair.

Risk factors for POUR include:

• increasing age
• anticholinergic medication
• history of urinary retention
• constipation
• out-of-hours surgery
• involvement of urinary bladder with the hernia
• temporary intraoperative urethral catheterization
• increasing operative duration.

“These findings could inform preoperative patient counseling,” the researchers concluded. “Awareness of modifiable risk factors may help to identify patients at increased risk of POUR who may benefit from perioperative risk mitigation strategies.”