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Postherniorrhaphy urinary retention--effect of local, regional, and general anesthesia: a review
Peter Jensen1, Trine Mikkelsen, Henrik Kehlet
1Department of Surgical Gastroenterology 435, University of Copenhagen, Hvidovre Hospital, Hvidovre, Denmark.
Background And Objectives:
Postherniorrhaphy urinary retention (UR) may depend on the anesthetic technique. We therefore reviewed available published studies of UR in relation to anesthetic technique.
Methods:
A Medline-based search (1966-November 2001) revealed 70 nonrandomized and 2 randomized studies.
Results:
The incidence of UR was lower with local anesthesia (LA) (33 in 8991 patients, 0.37%, 95% confidence interval [CI] 0.24%-0.49%) compared with regional anesthesia (RA) (150 in 6191 patients, 2.42%, 95% CI 2.04%-2.81%) and general anesthesia (GA) (344 in 11471 patients, 3.00%, 95% CI 2.69%-3.31%).
Conclusion:
The low incidence of UR with LA is in accordance with the inhibitory effects of RA and GA on bladder function. Data from newer short-acting techniques of GA and RA are required to define the optimal anesthetic for inguinal herniorrhaphy.