Urinary Retention After Haemorrhoidectomy: Impact of Stapled Haemorrhoidectomy

Abstract

Urinary retention is a common complication following haemorrhoidectomy. Stapled haemorrhoidectomy (SH) is associated with less postoperative pain, but whether or not this can reduce the incidence of urinary retention has not been evaluated. This study aimed to compare the incidence of urinary retention in patients treated with SH with those treated with conventional haemorrhoidectomy (CH). Charts of patients who underwent haemorrhoidectomy between May 2000 and March 2003 were reviewed. Data on demographics of patients, operative procedures, modes of anaesthesia, postoperative hospital stay and morbidities including urinary retention were collected. Factors that might affect the incidence of urinary retention were analysed by univariate and multivariate analyses. During the study period, 204 patients (100 men and 104 women; mean age, 49 years; age range, 20-82 years) underwent haemorrhoidectomy. SH was performed in 90 (44.1%) patients while the other 114 (55.9%) had CH. Seventy patients (34.3%) were operated on as day cases. One hundred and seventeen (57.4%) patients underwent surgery under general anaesthesia and 87 (42.6%) were operated on under spinal anaesthesia. Urinary retention occurred in 31 patients (seven with SH and 24 with CH, p = 0.009). Logistic regression showed that general anaesthesia (p = 0.044; odds ratio [OR], 2.43; 95% confidence interval [CI], 1.02-5.97) and SH (p = 0.046; OR, 2.66; 95% CI, 1.02-7.00) were independent factors associated with a lower incidence of urinary retention. The incidence of urinary retention following haemorrhoidectomy was 15.2%. General anaesthesia and SH were independent significant factors associated with a lower incidence of urinary retention.