評估腹股溝疝氣修補術後發生尿滯留的發生率及其危險因子
謝尚儒、陳國鋅1、鍾旭東2、吳維哲2、俞錫全2
1亞東紀念醫院 外科部 一般外科；2亞東紀念醫院 外科部 泌尿科
Assessing the incidence and risk factors for postoperative urinary retention following inguinal hernioplasty
Shang-Ju Hsieh, Kuo-Hsin Chen1, Shiu- Dong Chung2, Wei-Che Wu2, Shyi-Chun Yii2
Division of General surgery1, Department of Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan; Division of Urology2 Department of Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan
Purpose: The incidence of postoperative urinary retention (PUR) following inguinal hernioplasty was previously reported to range from 0.37% to 22.2%. Our aim of this study is to determine the incidence of PUR and identify patient risk factors for PUR following either open or laparoscopic method hernioplasty.
Materials and Methods: Data on patients from a single center, Far Eastern Memorial Hospital including baseline characteristics, comorbidities, perioperative and postoperative information were collected and reviewed retrospectively from the period of May to September 2018. Statistical analysis was conducted on patient’s characteristics, medical histories, anesthesia notes and postoperative notes to identify potential risk factor associated with PUR.
Results: A total of 244 patients were initially identified. 10 patients were excluded due to presenting with unstable vital signs before the surgery ( n=9 ) or combined with other urolithiasis surgery ( n=1 ). In the 234 patient included for analysis, PUR occurred in 19 patients, an incidence of 8.1%. Spinal anesthesia, age ≥ 60, history of benign prostate hyperplasia and usage of postoperative analgesics injection were associated with higher rates of PUR (p<0.05). On the other hand, no difference in PUR rates were found in gender, operation method, and anesthesia time.
Conclusion: Age ≥ 60, history of benign prostate hyperplasia, acceptance of spinal anesthesia and usage of postoperative analgesic injection are four risk factors associated with the development of PUR in patients following inguinal hernioplasty surgery. Therefore, additional medical care may be needed in these population for prevention of PUR.