Elderly men on anticholinergic medication more prone to develop urinary Retention Post Inguinal Hernia Repair: JAMA

A recent study published in the Journal of American Medical Association investigated the incidence and risk factors for postoperative urinary retention (POUR) following inguinal hernia repair (IHR). The study, known as RETAINER I, included a consecutive sample of adult patients undergoing elective IHR across 209 centers in 32 countries.

The findings of the study showed that POUR occurred in approximately 5.8% of male patients and 2.97% of female patients who underwent IHR. Notably, the incidence of POUR was significantly higher in male patients aged 65 years or older, affecting 9.5% of this population.

Several risk factors were identified through adjusted analyses. These included increasing age, the use of anticholinergic medication, history of urinary retention, constipation, out-of-hours surgery, involvement of the urinary bladder within the hernia, temporary intraoperative urethral catheterization, and longer operative duration. These findings highlight the importance of considering these factors during preoperative assessments and patient counseling.

The consequences of POUR were also examined in the study. Postoperative urinary retention was the primary reason for 27.8% of unplanned day-case surgery admissions and 51.8% of 30-day readmissions. These figures emphasize the impact of POUR on healthcare utilization and highlight the need for effective risk mitigation strategies to minimize the occurrence of this complication.

The RETAINER I study sheds light on the incidence, risk factors, and consequences of POUR following IHR. The results provide valuable insights for healthcare professionals involved in the management of patients undergoing this procedure. By identifying modifiable risk factors, clinicians can implement appropriate strategies to mitigate the risk of POUR and optimize patient outcomes.

The findings of this study serve as an important contribution to the field, informing clinical practice and enhancing patient care. Further research in this area may focus on the development of tailored interventions and risk assessment tools to improve patient outcomes and reduce the incidence of POUR in the future.

Source:

Croghan, S. M., Mohan, H. M., Breen, K. J., McGovern, R., Bennett, K. E., Boland, M. R., Elhadi, M., Lonergan, P. E., McDermott, F., Winter, D. C., Bolger, J. C., Farinelli, P. A., … Alaniz Alday, M. J. (2023). Global Incidence and Risk Factors Associated With Postoperative Urinary Retention Following Elective Inguinal Hernia Repair. In JAMA Surgery. American Medical Association (AMA). https://doi.org/10.1001/jamasurg.2023.2137