Clinique de Chirurgie Digestive et Endocrinienne (CCDE), Institut des Maladies de l'Appareil Digestif (IMAD), University Hospital of Nantes, 1, Place Alexis Ricordeau, 44093, Nantes, France.
Unité de Chirurgie Viscérale et Digestive, Hôpital Privé ďAntony, 1, Rue Velpeau, 92160, Antony, France.
World J Surg. 2020 Aug;44(8):2638-2646. doi: 10.1007/s00268-020-05538-7.
Urinary retention is one of the most common early postoperative complications following inguinal hernia repair (IHR). The aim of this study was to assess the incidence of postoperative urinary retention (POUR) and to identify associated risk factors.
Data of consecutive patients undergoing IHR from 2011 to 2017 were collected from a national multicenter cohort. POUR was defined as the inability to void requiring urinary catheterization. A multivariate analysis was conducted to identify independent risk factors for POUR.
Of 13,736 patients, 109 (0.8%) developed POUR. Patients with POUR had longer hospital length of stay (p < 0.001). IHR was performed by a laparoscopic or an open approach in 7012 (51.3%) and 6655 (48.7%) patients, respectively, and spinal anesthesia was realized in 591 (4.3%) patients. Ambulatory surgery was performed in 10,466 (76.6%) patients. Multivariate analysis identified preoperative dysuria (0R 3.73, p < 0.001), diabetes mellitus (OR 1.98, p = 0.029) and spinal anesthesia (OR 7.56, p < 0.001) as independent preoperative risk factors associated with POUR. POUR was the cause of ambulatory failure in 35 (10.2%) patients who required unanticipated admission.
The incidence of POUR following IHR remains low but impacts hospitalization settings. Preoperative risk factors for POUR should be considered for the choice of the anesthetic technique.
尿潴留是腹股沟疝修补术后（IHR）最常见的早期术后并发症之一。本研究旨在评估术后尿潴留（POUR）的发生率，并确定相关的危险因素。
从 2011 年至 2017 年，从一个全国多中心队列中收集了连续接受 IHR 的患者数据。POUR 定义为无法排尿需要导尿。进行多变量分析以确定 POUR 的独立危险因素。
在 13736 名患者中，有 109 名（0.8%）发生 POUR。有 POUR 的患者住院时间更长（p<0.001）。IHR 分别通过腹腔镜或开放式方法在 7012 名（51.3%）和 6655 名（48.7%）患者中进行，591 名（4.3%）患者接受脊髓麻醉。10466 名（76.6%）患者接受日间手术。多变量分析确定术前排尿困难（OR 3.73，p<0.001）、糖尿病（OR 1.98，p=0.029）和脊髓麻醉（OR 7.56，p<0.001）是与 POUR 相关的独立术前危险因素。35 名（10.2%）患者因意外入院而需要接受日间手术失败，其中 POUR 是导致日间手术失败的原因。
IHR 后 POUR 的发生率仍然较低，但会影响住院环境。应考虑 POUR 的术前危险因素来选择麻醉技术。
