Woo H H, Carmalt H L
Department of Surgery, Concord Hospital, N.S.W., Australia.
Int Urol Nephrol. 1995;27(5):557-62. doi: 10.1007/BF02564741.
Acute urinary retention is a frequent complication following inguinal hernia repair. The smooth muscle of the bladder neck and the prostate have been demonstrated to be rich in alpha-1 adrenergic receptors. It has been postulated that the aetiology of acute urinary retention postoperatively is at least partially due to adrenergic stimulation; blocking these receptors may reduce the incidence of acute urinary retention. We have used prazosin in a double blind, placebo controlled study to establish its efficacy in the prevention of acute urinary retention in patients undergoing elective inguinal hernia repair. A total of 70 male patients were enrolled; 36 patients had been allocated active drug and 34 patients had been allocated placebo. Only two patients developed acute urinary retention. Both patients had been allocated prazosin and had received a general anaesthetic for their hernia surgery. In either arm of the study, a higher number of patients developing urinary retention would have been expected but this may be explained by the greater vigilance on urinary output by nursing staff aware that the trial was being conducted. On the basis of our findings, we do not recommend the routine use of perioperative prazosin with inguinal hernia repair. Further studies in high risk groups would be necessary to assess more fully the efficacy of prazosin in this situation.
急性尿潴留是腹股沟疝修补术后常见的并发症。膀胱颈和前列腺的平滑肌已被证实富含α-1肾上腺素能受体。据推测，术后急性尿潴留的病因至少部分归因于肾上腺素能刺激；阻断这些受体可能会降低急性尿潴留的发生率。我们在一项双盲、安慰剂对照研究中使用哌唑嗪，以确定其在预防择期腹股沟疝修补术患者急性尿潴留方面的疗效。总共招募了70名男性患者；36名患者被分配使用活性药物，34名患者被分配使用安慰剂。只有两名患者发生急性尿潴留。这两名患者均被分配使用哌唑嗪，并接受了疝修补术的全身麻醉。在研究的任何一组中，预计会有更多患者发生尿潴留，但这可能是因为参与试验的护理人员对尿量更加警惕。根据我们的研究结果，我们不建议在腹股沟疝修补术中常规使用围手术期哌唑嗪。有必要在高危人群中进行进一步研究，以更全面地评估哌唑嗪在这种情况下的疗效。
