Postoperative Urinary Retention After Hernia Repair: A Randomized Controlled Trial Identifying Patients at Risk and...

Postoperative urinary retention following hernia repair is a common complication, with its incidence ranging from 2%-30%. Treatment typically consists of a 5-alpha-reductase inhibitor, like tamsulosin. The goal of this study was to identify whether pretreatment with tamsulosin 7 days prior to an elective hernia repair reduced the rate of postoperative urinary retention.

A single institution randomized controlled trial was conducted with 140 patients. Patients were randomly assigned to either a control or treatment group, with all patients completing a pre- and postoperative International Prostate Symptom Score (IPSS). The inclusion criteria were men with no history of tamsulosin usage and who were undergoing elective hernia repair. Urinary retention was measured postoperatively by either placement of a urinary catheter or a subjective inability to void.

The incidence of urinary retention of patients included in the study was 17.5%. Postoperative urinary retention was noted in 10 of the 66 patients in the treatment arm and 12 of the 60 in the control arm. Statistical evaluation did not reveal a significant difference between the treatment and control groups (P = .492). Though our original intervention of alpha-blockade did not have an impact on postoperative urinary retention rates, we did discover a statistically significant difference in the preoperative IPSS between patients who had postoperative urinary retention and those who did not (P = .013).

Seven days of preoperative tamsulosin did not show a statistically significant reduction in postoperative urinary retention in men undergoing elective hernia operations. However, the subgroup analysis did reveal a statistically significant difference in the preoperative IPSS of patients who had postoperative urinary retention and those who did not, possibly indicating that the IPSS could be used as a predictive tool in the future.