EP45 - Improving Management of Patients undergoing Inguinal Hernia Repair Who Experience Post-Operative Urinary Retention

Abstract

Abstract Aims Post-operative urinary retention (POUR) is a common complication following inguinal hernia repair. Left untreated POUR can result in significant patient discomfort, acute kidney injury, detrusor muscle damage and infection. It was observed that the detection and management of POUR in our trust following planned day case inguinal hernia repair was varied, often resulting in unplanned admission. We therefore carried out a review of how our trust is managing these patients. Methods A retrospective analysis of all patients undergoing planned day case inguinal hernia repair in a single institution between March 2023 and August 2023 was performed. Patients having open, laparoscopic, or robotic repair were included. Data was collected on demographics, documentation of POUR, time to diagnosis, bladder scan volume, catheterisation, overnight stay and follow up for all patients. Results 124 patients underwent inguinal hernia repair. 13 patients reported experiencing POUR (10.4%). 9 patients experienced POUR during their initial admission, of which 8 had unplanned overnight admissions. 5 patients were not managed with catheterisation despite having significant volume of urine detected on bladder scan (>700ml). Time to diagnosis varied with POUR not being detected for 24 hours for one patient. 4 patients went into retention after discharge and re-presented via the emergency department. Conclusion Significant variation in the detection and management of patients with POUR was noted in this cohort. Introduction of a POUR pathway in day-surgery describing both diagnosis and management has therefore been created to try and address this, to improve outcomes and reduce hospital admission.