732 Does Intraoperative Urinary Catheterisation Decrease Postoperative Urinary Retention After Laparoscopic Inguinal Hernia Repair? a Systematic Review and Meta-Analysis

Abstract

Abstract Aim To evaluate comparative outcomes of laparoscopic inguinal hernia repair with and without use of intraoperative urinary catheterisation. Method A systematic search of MEDLINE, CENTRAL and Web of Science and bibliographic reference lists were conducted. All comparative studies evaluating outcomes of laparoscopic inguinal hernia repair with and without use of intraoperative urinary catheterisation were included and their risk of bias were assessed using their risk of bias were assessed using ROBINS-I tool. Postoperative urinary retention was analysed as the primary outcome parameter and an odds ratio (OR) was determined using Random-effects modelling. Results We included 6 comparative studies reporting a total of 8,675 patients who underwent laparoscopic inguinal hernia repair with (n=3,318) and without (n=5,357) use of intraoperative urinary catheterisation. There was no significant difference in postoperative urinary retention between the two groups (4.3% versus 3.7%, OR 0.93; 95% CI 0.55-1.58, p=0.80). There was significant heterogeneity among the included studies (I2: 75%, p=0.001). Results of sensitivity analyses were consistent with the results of the main analysis. Conclusions Meta-analysis of best available evidence (level 2a) demonstrated that use of intraoperative urinary catheter has no advantage in prevention of postoperative urinary retention following laparoscopic inguinal hernia repair. Future randomised controlled trials are required to control for confounding factors that increases the risk of urinary retention.