Postoperative Urinary Retention In Patients Research Articles

Development and validation of a nomogram to predict acute postoperative urinary retention in ischemic stroke patients following femoral artery puncture.

Acute postoperative urinary retention (POUR) is a common complication in patients with ischemic stroke following femoral artery puncture (FAP), leading to discomfort, delayed hospital discharge, and increased patient morbidity. The relevant risk factors are unclear; thus, a predictive tool is required to guide treatment decisions. To develop and validate a nomogram to predict acute POUR in patients with ischemic stroke following FAP. We retrospectively collected cases from 1729 patients with ischemic stroke from the electronic record system of Jiangmen Central Hospital from January 2021 to December 2023. A total of 731 patients were randomly divided into development (n = 511, 70%) and validation (n = 220, 30%) groups. Univariate and multivariate logistic regression analyses with backward stepwise regression were used to select the predictive variables, and a nomogram was developed. The discrimination was evaluated based on the area under the curve (AUC). Calibration was assessed using calibration plots and the Hosmer-Lemeshow test. Clinical applications were evaluated using decision curve analysis (DCA). The incidence of acute POUR was 12.72%. Preoperative statin use within 24 h, operation type, intraoperative infusion, postoperative water intake within 3 h, postoperative pain, and postoperative anxiety were included in the nomogram. The AUC values were 0.764 [95% confidence interval (CI): 0.705-0.825] in the development group and 0.741 (95% CI: 0.615-0.856) in the validation group. The calibration plots showed good calibration. The p values in the Hosmer-Lemeshow tests were 0.962 and 0.315 for the development and validation groups, respectively. The DCA showed that patients could benefit from this nomogram. A nomogram was developed to successfully predict acute POUR in patients with ischemic stroke following FAP. This nomogram is a convenient and effective tool for clinicians to aid in the prevention and early intervention of acute POUR.

Risk factors for postoperative urinary retention in patients underwent surgery for benign anorectal diseases: a nested case–control study

BackgroundPostoperative urinary retention (POUR) is a common complication of anorectal surgery. This study was to determine the incidence of POUR in anorectal surgery for benign anorectal diseases, identify its risk factors, and establish a nomogram for prediction of POUR.MethodsA nested case–control study was conducted. The clinical data of patients were collected, and the incidence of POUR was analyzed. Univariate analysis was used to identify the risk factors associated with POUR, and multivariate logistic regression analysis was used to determine independent risk factors for POUR. A nomogram for the preoperative prediction of POUR using a logistic regression model was developed (n = 609).ResultsThe incidence of POUR after anorectal surgery for benign anorectal diseases was 19.05%. The independent risk factors for POUR were: female (P = 0.007); male with benign prostatic hyperplasia (BPH) (P = 0.001); postoperative visual analogue scale (VAS) score > 6 (P = 0.002); patient-controlled epidural analgesia (PCEA) (P = 0.016); and a surgery time > 30 min (P = 0.039). In the nomogram, BPH is the most important factor affecting the occurrence of POUR, followed by a postoperative VAS score > 6, PCEA, surgery time > 30 min, and sex has the least influence.ConclusionFor patients undergoing anorectal surgery for benign anorectal diseases, preventive measures can be taken to reduce the risk of POUR, taking into account the following risk factors: female or male with BPH, severe postoperative pain, PCEA, and surgery time > 30 min. Furthermore, we developed and validated an easy-to-use nomogram for preoperative prediction of POUR in anorectal surgery for benign anorectal diseases.Trial registrationChina Clinical Trial Registry: ChiCTR2000039684, 05/11/2020.

Decreasing Post-operative Urinary Retention in Patients

Decreasing Post-operative Urinary Retention in Patients

The Effect of Magnetic Therapy on Postoperative Urinary Retention in Patients Undergoing Surgery: A Randomized Clinical Trial.

Urinary retention is a postoperative problem that causes pain and discomfort for patients, even when catheters are used. The potential role of magnetic therapy in treating postoperative urinary retention through acupuncture points remains uncertain. This research aims to assess the impact of magnetic therapy on urinary retention in patients undergoing surgery. This single-blind clinical trial study was conducted in a recovery department within an operating room and subsequently in the Surgery Department of Amin Hospital. The study took place in Isfahan in 2022, with a sample of 64 patients selected using a simple random sampling method and divided equally into two groups. In the intervention group, magnet plates were applied, while the control group received iron plates at seven specific points for duration of 35 ± 5 minutes. Demographic information, the type of urinary excretion, the duration of urinary retention, and the volume of excreted urine were recorded using a researcher-made checklist for both intervention and control groups. These data were compared and subjected to descriptive and analytical statistical analysis. Among the participants (N = 64), the majority were male (N = 37, 57.80%), and the mean age was 40.17 years. The Chi-square analysis revealed no significant difference between the intervention and control groups in terms of the type of urinary excretion (p = 0.106). However, the Mann-Whitney U-test demonstrated significant difference between the two groups regarding the duration required to eliminate urinary retention and the volume of excreted urine (F2,41 = 62 and F1,76 = 62; p < 0.001). The use of a novel approach involving magnetic therapy applied to acupuncture and reflexology points has been shown to reduce the time required for the first urination and increase the volume of urine in post-surgery patients.

Effectiveness of Electroacupuncture for Managing Urinary Retention Post Lumbar Spine Surgery: a retrospective single-cohort study.

Post-operative urinary retention (POUR) is a frequent complication following surgical procedures, characterized by an acute inability to void, leading to additional complications and extended hospitalization. Acupuncture has been shown to be effective in facilitating spontaneous urination and alleviating anxiety in patients experiencing poor urination. The present study aims to evaluate the effectiveness of electroacupuncture in the management of POUR in patients who have undergone lumbar spine surgery. This retrospective study conducted at the National Hospital of Acupuncture in Vietnam and reviewed the medical records of patients over 18 years old who underwent lumbar spine surgery and were diagnosed with POUR between January to December 2019. Electroacupuncture was administered at five specific acupuncture points Qugu (CV2), Zhongji (CV3), Zhibian (BL54), Pangguanshu (BL28), and Kunlun (BL60). This study monitored key parameters related to the effectiveness of the acupuncture treatment, including the number of acupuncture treatment sessions required until a patient was successfully treated was recorded, with a maximum of three acupuncture treatment sessions per patient, the time elapsed until urination following the treatment (minutes), and urinary bladder volume before and after treatment (mL). The study demonstrated a 93.3% success rate in treating POUR with electroacupuncture. A significant reduction in post-void residual volume was noted, and patients could void within 30 minutes post-treatment. No significant differences in treatment effectiveness were observed across difference genders and age groups. Electroacupuncture proved to be a highly effective treatment for POUR in patients post-lumbar spine surgery, with a rapid response time and substantial reduction in PVR. However, the retrospective nature of the study and single-center focus limit its generalizability. Future research incorporating randomized controlled trials or multi-center observational studies are recommended to validate these findings and explore the potential of acupuncture in POUR management on a broader scale.

Risk factors for postoperative urinary retention in fragility hip fracture patients: a prospective study

BackgroundPostoperative urinary retention (POUR) among older patients with hip fractures is common and may result in delayed ambulation, prolonged hospital stays, and urinary tract infections. Although preoperative urinary catheter indwelling and early postoperative removal can prevent perioperative urinary retention, this condition may occur in some patients after catheter removal, which requires urinary catheter re-indwelling or intermittent catheterization. Therefore, this study aims to identify risk factors and develop a screening tool for postoperative urinary retention in patients who have undergone operative treatment for fragility hip fractures subsequent to urinary catheter removal.MethodsA prospective cohort study of 145 fragility hip fracture in older patients who were operatively treated between September 2020 and May 2022 was conducted. All patients were evaluated for urine retention after urinary catheter removal using a bladder scan. In addition, factors related to urinary retention were collected and utilized for screening tool development.ResultsOf the included patients, 22 (15.2%) were diagnosed with POUR. A multivariable logistic regression model using a stepwise backward elimination algorithm identified the current use of drugs with anticholinergic effect (OR = 11.9, p = 0.012), international prostate symptom score (IPSS) ≥ 8 (OR = 9.3, p < 0.001), and inability to independently get out of bed within 24 h postoperatively (OR = 6.5, p = 0.051) as risk factors of POUR. The screening tool that has been developed revealed an excellent performance (AuROC = 0.85, 95%CI 0.75 to 0.91) with good calibration and minimal optimism.ConclusionsCurrent use of drugs with anticholinergic effects, IPSS ≥ 8, and inability to independently get out of bed within 24 h postoperatively are significant variables of POUR. For additional external validation, a proposed scoring system for POUR screening was developed.Trial registrationThe study protocol was retrospectively registered in The Thai Clinical Trials Registry (TCTR20220502001: 2 May 2022).

Enhanced recovery urinary protocol for patients undergoing hip surgery: a quasi-experimental study.

Postoperative urinary retention (POUR) is a common complication after hip surgery. The enhanced recovery urinary protocol (ERUP) is a tool that employs several perioperative strategies to facilitate optimal conditions for surgery and recovery. The aim of this study was to evaluate the effect of ERUP on POUR in patients undergoing hip surgery. A controlled pre- and post-quasi-experimental study was conducted. Data was collected between May 2018 and January 2019 at the orthopedic department of one of the largest teaching hospitals affiliated with Menoufia University in Egypt. A convenience sample of 100 Egyptian patients (of both genders) undergoing elective hip surgery was equally allocated into two groups. The control group (n = 50) was given traditional routine perioperative nursing care, while the intervention group (n = 50) was subjected to ERUP. Data was collected from socio-demographic, medical, and surgical data sheets, preoperative medication assessment sheets, postoperative data sheets, and fluid balance charts. ERUP application significantly reduced the length of hospital stay and the incidence of POUR in the intervention group. Implementation of the ERUP is recommended for patients undergoing hip surgery, as it has a significantly positive effect on reducing the incidence of POUR.

Postoperative urinary retention in colorectal surgery patients on an enhanced surgical recovery pathway

Abstract Introduction: Postoperative urinary retention (POUR) is a complication of surgery defined as the inability to empty a full bladder. POUR can prolong hospital length of stay and increase rates of urinary tract infection in the postoperative period. Risk factors for the development of POUR include male sex, older age, select medications, and certain comorbid conditions. Surgical factors may also increase the risk of POUR. POUR occurs in up to 50% of patients undergoing colorectal surgery. Materials and Methods: This retrospective, single-center cohort study evaluated the incidence of POUR in patients admitted for colorectal surgery and were enrolled in a Colorectal Enhanced Surgical Recovery (CERAS) protocol. Our primary objective was to determine the incidence of POUR in patients treated under the CERAS protocol. Secondary objectives included evaluating the incidence of POUR in patients receiving intrathecal anesthesia. Results: Two hundred and twenty-eight patients were included. Sixty-six patients (28.9%) developed POUR during their hospitalization. Patients who developed POUR were more likely to be male (61.6% vs. 44.4%, P = 0.029) and tended to be older (mean ± standard deviation age, 61.4 ± 17.7 years vs. 56.8 ± 16.4 years; P = 0.069) compared to the non-POUR group. Regional anesthesia did not affect the incidence of POUR. Conclusions: We identified a rate of POUR in our CERAS patients consistent with previous studies. The risk of POUR increased with increasing age, male sex, and history of benign prostatic hyperplasia and diabetes mellitus. We found no difference in POUR incidence with the type of regional anesthesia utilized. The following core competencies are addressed in this article: Practice-Based Learning and Improvement and Medical Knowledge.

Research progress of moxibustion for postoperative urinary retention in patients with hip fracture

Research progress of moxibustion for postoperative urinary retention in patients with hip fracture

Prophylactically Given Tamsulosin in Preventing Postop Urinary Retention in Surgery Under Spinal Anaesthesia

Aim: To determine effect of tamsulosin in the prevention of post operative urinary retention in patients undergoing spinal anesthesia Study design: Randomized control trial Place and duration of study: Urology Department, Mayo Hospital, KEMU, Lahore February 2020- February 2021 Methodology: Only 106 patients (53 individuals in each group) were included in the study with non probability purposive sampling. The patients undergoing surgery under spinal anaesthesia were either given tamsulosin in one group and not given tamsulosin in other group. Postoperatively patients were monitored for urinary retention. SPSS-26 was used for analyzing the data. Result: Incidence of postoperative urinary retention was significantly higher in placebo group as compared to Tamsulosin group. i.e. (overall result of 26.42 vs 3.77%, p-value=0.001 and 26% vs 2.5% in hernia group and 33.3 vs 7.7 % in hydrocele group) Conclusion: Prophylactically given tamsulosin helps in preventing postoperative urinary retention in patients undergoing surgery under spinal anaesthesia. Keywords: Postoperative urinary retention, Tamsulosin, Spinal Anaesthesia

Prophylactic alpha-blockade for prevention of post-operative urinary retention after inguinal hernia repair: a systematic review and meta-analysis.

The rate of post-operative urinary retention (POUR) in inguinal hernia repairs (IHR) is estimated to be approximately 5.9% to 38% worldwide. Currently, there are minimal studies on the prophylaxis of POUR after IHR. Pre-operative administration of alpha-blockers such as (but not limited to) Tamsulosin, Prazosin and Alfuzosin has shown promising results in the prevention of POUR in patients undergoing IHR. This study aims to determine the effectiveness of prophylactic alpha-blockade in the prevention of POUR after IHR. This study reports the findings of a systematic review and meta-analysis. Randomised controlled trials (RCTs) using prophylactic alpha-blockade for the prevention of POUR after open and/or laparoscopic IHR in patients aged more than 18years in all sex groups were included. Multiple databases were searched from inception to October 2021 using the PRISMA flow diagram. Data were extracted and analysed to include eligibility criteria, comparator, intervention, study and participant characteristics. Studies excluded were non-RCT studies and patients with known urinary tract disorders such as benign prostate hypertrophy, urinary incontinence and cancer of the bladder or prostate. Subgroup analyses were also conducted. All effect measures of each data were odds ratio with 95% confidence interval. All studies were pooled using the dichotomous random effects Mantel-Haenszel statistical mode and I2 was used to assess heterogeneity. Publication bias was detected using the Cochrane risk-of-bias tool for randomised trials (RoB-2) involving two independent reviewers. A total of eight RCTs were identified which provided adequate numeric data for incorporation into the meta-analysis. Overall, administration of pre-operative alpha-blocker prior to IHR did not prevent POUR (95% CI 1.20 (0.96-1.49), I2: 34%). Subgroup analysis comparing pre-operative use of prophylactic alpha-blocker in open versus laparoscopic IHR has shown statistically significant reduction of POUR prevention in the laparoscopic group (95% CI 0.66 (0.47-0.92)), I2: 43%). The older age group benefited from pre-operative alpha-blocker use with reduced incidence of POUR post-IHR (95% CI 0.14 (0.08, 0.23), I2: 0%)). Gender did not affect the difference of incidence of POUR post-IHR despite pre-operative alpha-blockers (95% CI 0.62 (0.27, 1.44)), I2: 53%)). Overall, this meta-analysis has shown that administration of prophylactic alpha-blockers did not prevent POUR. However, there was statistically significant reduction of POUR in patients undergoing laparoscopic IHR as compared to open, as well as in older patients (age more than 60years) after administration of pre-operative alpha-blocker. Hence, the use of pre-operative alpha-blocker especially in older patients should be considered and more RCTs should be undertaken.

Risk factors for postoperative urinary retention in patients undergoing colorectal surgery: a systematic review and meta-analysis.

Postoperative urinary retention (POUR) is a common complication following colorectal surgery. The incidence of POUR among colorectal surgery patients varies widely, and the risk factors and outcomes of POUR are also debatable. This meta-analysis aims to systematically evaluate the risk factors for POUR in patients after colorectal surgery. PubMed, Web of Science, the Cochrane Library, Embase, Medline, and Chinese databases (CBM, CNKI, and WanFang Databases) were searched to identify relevant cohort studies (from inception to August 2022). Two researchers independently conducted literature quality evaluation and data extraction. All data were analyzed by using the Review Manager 5.4 software. Nineteen studies with 101,025 patients were included in this meta-analysis. The risk factors for POUR in colorectal surgery patients were male sex, older age, diabetes mellitus, urological diseases, tumor location in the lower rectum, APR, laparoscopic surgery, operation time ≥ 4h, postoperative date of urinary catheter removal, excessive intraoperative intravenous fluid volume, and postoperative ileus. The postoperative anastomotic leak, on the other hand, was not a risk factor for POUR. Multiple risk factors influence the incidence of POUR in patients undergoing colorectal surgery. To reduce the incidence of POUR in colorectal surgery patients, medical staff should identify risk factors early and enforce interventions to prevent them.

Factors associated with postoperative urinary retention in patients undergoing penile prosthesis implantation.

Placement of penile prosthesis had been well described in the outpatient setting, however, one barrier to same-day discharge is postoperative urinary retention (POUR). POUR remains a condition encountered during ambulatory surgical procedures and has yet to be characterized in patients undergoing penile prosthesis. We characterized POUR in a cohort of penile prosthesis recipients along with risk factors and management. Patients undergoing penile prosthesis implantation from 2014 through 2020 without pre-existing retention were included. All patients underwent a void trial immediately following penile prosthesis in the post-anesthesia care unit. POUR was strictly defined as (1) any patient requiring catheter replacement after prosthesis, (2) a rising post-void residual, or (3) inability to void after 6 h regardless of whether a catheter was placed. Independent procedures, demographic, intraoperative, and postoperative risk factors for POUR were assessed. 317 men were included of whom 27.1% experienced POUR. Men experiencing POUR and those not in retention were essentially indistinguishable with respect to previously described risk factors for POUR. Only use of both α-blockers and 5-α-reductase inhibitors was significantly associated with a greater risk of POUR, a finding maintained on adjusted analysis (adjusted odds ratio 10.1, 95% confidence interval 2.1 to 49.8). POUR resolved without intervention in 3.5%, a single episode of clean intermittent catheterization (CIC) in 7.0% of patients, and repeated CIC or indwelling catheter placement with a successful delayed void trial in 88.4% of patients. Rate of prosthesis infection in patients who experienced POUR did not significantly differ from those who did not experience POUR (4.7% vs. 2.2% p = 0.26). Our findings suggest that POUR is experienced in as many as 1 in 4 men undergoing penile prosthesis placement, most of whom must be managed with indwelling catheterization or repeated CIC. Those with indicators of symptomatic prostate enlargement are at significantly greater risk of urinary retention.

Does tamsulosin decrease postoperative urinary retention in spine surgery? A double-blind, randomized controlled trial.

The authors' objective was to determine whether preoperative administration of tamsulosin decreases postoperative urinary retention after spine surgery. In this randomized, double-blind, placebo-controlled clinical trial performed at a single institution between 2016 and 2019, eligible males aged 50 to 85 years were administered tamsulosin or placebo for 5 days prior to elective spine surgery. Patients were excluded if they were taking alpha adrenergic blocking drugs; were allergic to tamsulosin, lactose, or sulfa drugs; had a preexisting indwelling urinary catheter, orthostatic hypotension, history of urological surgery, or renal failure; or were scheduled for cataract surgery within 2 weeks. Screening identified 1051 eligible patients (140 declined participation, 150 did not meet the inclusion criteria, and 151 did not enroll for other reasons). A total of 610 patients were randomly assigned to receive 0.4 mg oral tamsulosin or an identical placebo capsule for 5 days preoperatively and 2 days postoperatively. A total of 497 patients were included in the final statistical analysis. The overall rate of postoperative urinary retention was 9.7%, and tamsulosin had no observed effect on reducing the rate of postoperative urinary retention as compared with placebo (9.4% vs 9.9%, p = 0.96). There were no significant differences in the reported adverse events between groups. Multivariate logistic regression was performed to model the effects of patient, surgical, and anesthetic factors on postoperative urinary retention, and the study drug remained an insignificant factor. This study did not detect an effect of perioperative tamsulosin on reducing the rate of postoperative urinary retention in male patients aged 50 to 85 years who underwent elective spine surgery. This study does not support the routine use of tamsulosin to reduce postoperative urinary retention in patients without a previous prescription. It is unknown if subpopulations exist for which prophylactic tamsulosin may reduce postoperative urinary retention.

Construction and Validation of a Risk Prediction Model for Postoperative Urinary Retention in Lung Cancer Patients.

Indwelling catheter is a routine procedure in surgical patients. Studies have shown that prolonged indwelling urinary catheterization increases the risk of postoperative urinary tract infection. Although early removal of the urinary catheter after operation can reduce the risk of postoperative urinary symptoms and tract infections, it may lead to postoperative anesthetic dysuria. Therefore, this study investigates the urinary retention and related risk factors in patients after thoracoscopic lobectomy under general anesthesia. The clinical data of 214 patients who underwent thoracoscopic lobectomy in the Department of Thoracic Surgery of a tertiary class A cancer hospital in Beijing from July 2020 to April 2021 were collected. A risk prediction model was established by logistic regression analysis, and the prediction effect was determined using the area under the receiver operating characteristic (ROC) curve. The incidence of indwelling catheter after thoracoscopic lobectomy was 44.8% (96/214). Sex (OR = 21.102, 95% CI: 2.906–153.239, P=0.003), perception of shame (OR = 74.256, 95% CI: 6.171–893.475, P=0.001), age (OR = 1.095, 95% CI: 1.014–1.182, P=0.021), and bed rest time (OR = 1.598, 95% CI: 1.263–2.023, P < 0.021) were the factors influencing urinary retention after thoracoscopic lobectomy. This model can effectively predict the occurrence of postoperative urinary retention in patients with lung cancer and help medical staff to intervene effectively before the onset of urinary retention, which provides reference for preventive treatment and nursing intervention.

Incidence, Outcomes and Risk Factors of Postoperative Urinary Retention in Patients Undergoing Primary Total Knee Arthroplasty: A National Inpatient Sample Database Study

Incidence, Outcomes and Risk Factors of Postoperative Urinary Retention in Patients Undergoing Primary Total Knee Arthroplasty: A National Inpatient Sample Database Study

Effect of Kegel Pelvic Floor Muscle Exercise Combined with Clean Intermittent Self-catheterization on urinary retention after radical hysterectomy for cervical cancer.

Objectives:To investigate the effect of Kegel pelvic floor muscle training combined with clean intermittent self-catheterization on patients with cervical cancer, and to analyze the risk factors affecting urinary retention.Methods:A total of 166 patients with cervical cancer admitted to our hospital from October 2016 to December 2019, all of whom received radical resection of cervical cancer, were divided into two groups according to the random number table method: the observation group and the control group, with 83 cases in each group. The control group underwent clean intermittent self-catheterization, while the observation group underwent Kegel pelvic floor muscle exercise combined with clean intermittent self-catheterization. The catheter replacement rate, bladder residual urine volume, self-perceived burden scale (SPB), Kolcaba general comfort questionnaire (GCQ), incidence of urinary tract infection, and urinary retention after catheter removal were compared between the two groups. Logistics regression analysis was utilized to analyze the risk factors affecting urinary retention.Results:The incidence of catheter replacement, urinary retention, dysuria and bladder residual urine volume in the observation group were significantly lower than those in the control group (P<0.05). Postoperative SPB score of the two groups decreased significantly, while the GCQ score increased significantly. Postoperative SPB score of the observation group was significantly lower than that of the control group, while the GCQ score was significantly higher than that of the control group (P<0.05). Statistically significant differences can be observed in the comparison of catheter indwelling time, urinary tract infection, surgical incision infection and surgical margin between the two groups (P<0.05). Logistic regression analysis showed that catheter indwelling time, urinary tract infection, surgical incision infection and surgical margin were independent risk factors affecting urinary retention (P<0.05).Conclusions:Catheter indwelling time, urinary tract infection, surgical incision infection and surgical margin are the risk factors for postoperative urinary retention in patients with cervical cancer. With Kegel pelvic floor muscle exercise combined with clean intermittent self-catheterization, a variety of benefits can be realized, such as improved bladder function, reduced incidence of urinary tract infections and urinary retention, as well as increased patient comfort.

Incidence and Risk Factors for Urinary Retention in Patients Undergoing Outpatient Hysterectomy

Objectives: The goals of this research were to identify the incidence of, and risk factors for, postoperative urinary retention in patients who underwent outpatient hysterectomy, and to evaluate th...

English

BACKGROUND After surgery, 1 / 4th of patients develop urinary retention. POUR (Post-Operative Urinary Retention) is clinically identifiable urinary bladder post-operatively. POUR occurs more frequently after hernia surgeries (both open and laparoscopic methods), lower urinary tract, perineal, gynaecologic, and anorectal surgeries. tamsulosin, being an alpha-1 receptor blocker, decreases the bladder neck tone and hence increases the efficiency of micturition. We wanted to evaluate tamsulosin in preventing POUR in patients who underwent laparoscopic groin hernioplasty. METHODS From January 2017 through January 2018, a total of 150 males more than 40 years of age who underwent laparoscopic inguinal hernia repair in Government T.D. Medical College were included in this study. In group 1, patients were given 0.4 mg Tamsulosin orally, 2 weeks before surgery and continued postoperatively and group 2 patients were selected from other units in surgery where tamsulosin was not used. CONCLUSIONS Tamsulosin, before and after surgery, is useful in reducing the incidence of POUR in patients undergoing elective laparoscopic inguinal hernia repair. KEYWORDS Laparoscopic Hernioplasty, Tamsulosin, Urinary Retention, Alpha Adrenergic Antagonist, Post-Operative Urinary Retention (POUR), Post-Voiding Residual Urine Volume (PRV) RESULTS There are 75 patients in group 1 (tamsulosin) and 75 patients in group 2 (control group). All the patients were male and the mean age in both the groups was almost similar. In tamsulosin group 5 patients (6.7 %), and in control group 14 patients (18.7 %) developed Post-Operative Urinary Retention (POUR). The type and side of hernia, duration of surgery, and post-voiding residual urine volume (PRV) were not effective in causing POUR. There was significantly lower incidence of post-operative urinary retention in Tamsulosin group compared to control group. The age, severity of seven pre-operative urinary symptoms and the prostate volume was statistically significant in patients who developed postoperative urinary retention in both groups.

Urinary retention is rare after colpocleisis and concomitant midurethral sling: a 10-year experience

The optimal method of managing stress urinary incontinence (SUI) in women undergoing colpocleisis remains unclear, especially in a setting of urinary retention. We aim to compare postoperative retention after colpocleisis with or without concomitant midurethral sling (MUS). A retrospective chart review of all women who underwent colpocleisis with or without MUS from October 2007 to October 2017 was performed. Women with preoperative and 2-week postoperative post-void residual volume (PVR) measurements were included. Urinary retention was defined as PVR of ≥100ml. Analysis included t tests/Wilcoxon rank, Chi-squared/Fisher's exact, and multivariate linear regression models. A total of 231 women with a mean age of 77.7years (± 6.0years SD) met the inclusion criteria. One hundred and thirty-eight women underwent colpocleisis alone, whereas 93 women had colpocleisis with MUS. Preoperative retention rates were high (44.9% vs 34.4%, for colpocleisis alone versus with MUS, p = 0.114). Postoperative retention rates were lower and similar between the groups (10.1% vs 11.8%, for colpocleisis alone vs with MUS, p = 0.69). Linear regression models showed the adjusted odds ratio for postoperative urinary retention in patients with concomitant MUS was 1.68 (95% confidence interval: 0.64-4.41) compared with patients with colpocleisis alone and this did not reach statistical significance (p = 0.292). Fortunately, after colpocleisis, women had high rates of resolution of retention, regardless of MUS (80.3% vs 90.6% for colpocleisis alone vs with MUS; p = 0.20). Few women required reoperation for retention (3.1%). Placement of an MUS at the time of colpocleisis is a safe and effective therapy. This appears to be unaffected by preoperative urinary retention status.