Skip to main content

Advertisement

SpringerLink
Log in

The use of tamsulosin to prevent postoperative urinary retention in laparoscopic inguinal hernia repair: a randomized double-blind placebo-controlled study

  • Published:
Surgical Endoscopy Aims and scope Submit manuscript

Abstract

Purpose

The rate of postoperative urinary retention (POUR) in laparoscopic inguinal hernia repairs is 1–22%. POUR may cause patient anxiety, discomfort, and increased hospital costs. Currently there is no standard prophylaxis for POUR. Preoperative administration of tamsulosin has been shown to decrease POUR rates in urologic studies. This study aims to evaluate the efficacy of tamsulosin on the incidence of POUR in patients undergoing totally extraperitoneal (TEP) LIHR.

Methods

A randomized, double-blinded, placebo-controlled trial was initiated and accrued patients from 2017 to 2019. A total of 169 males undergoing elective TEP LIHR were included. Patients were administered tamsulosin 2 h before surgery and followed for up to 24 h postoperatively for episodes of POUR. Analysis was performed to quantify the association between patient, surgical, and perioperative factors with POUR.

Results

The overall rate of POUR was 9%. There was no difference in the rate of POUR between the placebo (9.9%) and tamsulosin groups (7.9%) (p = 0.433). Univariate analysis showed a trend toward POUR in patients with history of benign prostatic hypertrophy (BPH) (p = 0.058). Previously reported risk factors of older age, total IVF, length of procedure and opioid use were not associated with increased rates of POUR. Tamsulosin reduced the time to discharge by 4 to 68 min when compared to placebo.

Conclusions

This study suggests that preoperative administration of tamsulosin may not reduce the risk of POUR in males undergoing elective TEP LIHR. Further study with a larger sample size may be needed to show a statistically significant difference.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Matthews RD, Neumayer L (2008) Inguinal hernia in the 21st century: an evidence-based review. Curr Probl Surg 45(4):261–312

    Article  Google Scholar 

  2. Bittner R, Arregui ME, Bisgaard T et al (2011) Guidelines for laparoscopic (TAPP) and endoscopic (TEP) treatment of inguinal hernia [International Endohernia Society (IEHS)]. Surg Endosc 25(9):2773–2843

    Article  CAS  Google Scholar 

  3. Baldini G, Bagry H, Aprikian A et al (2009) Postoperative urinary retention: anesthetic and perioperative considerations. Anesthesiology 110(5):1139–1157

    Article  Google Scholar 

  4. Zayadin Y, D’John J, Yaldo B et al (2019) Urinary retention post open vs laparoscopic vs robotic inguinal hernia repair: a comparative retrospective review. J Am Coll Surg 229(4):e129

    Article  Google Scholar 

  5. Blair AB, Dwarakanath A, Mehta A et al (2017) Postoperative urinary retention after inguinal hernia repair: a single institution experience. Hernia 21(6):895–900

    Article  CAS  Google Scholar 

  6. Sivasankaran MV, Pham T, Divino CM (2014) Incidence and risk factors for urinary retention following laparoscopic inguinal hernia repair. Am J Surg 207(2):288–292

    Article  Google Scholar 

  7. Tse W, Johnson R, Savas J et al (2019) What is the cost of that ER visit? An analysis of inguinal hernia repairs and non-scheduled follow-up. J Am Coll Surg 229(4):e130

    Google Scholar 

  8. Gönüllü NN, Dülger M, Utkan NZ et al (1999) Prevention of postherniorrhaphy urinary retention with prazosin. Am Surg 65(1):55–58

    PubMed  Google Scholar 

  9. Goldman G, Leviav A, Mazor A et al (1988) Alpha-adrenergic blocker for posthernioplasty urinary retention. Prev Treat Arch Surg 123(1):35–36

    Article  CAS  Google Scholar 

  10. Mohammadi-fallah M, Hamedanchi S, Tayyebi-azar A (2012) Preventive effect of tamsulosin on postoperative urinary retention. Korean J Urol 53(6):419–423

    Article  Google Scholar 

  11. Madani AH, Aval HB, Mokhtari G et al (2014) Effectiveness of tamsulosin in prevention of post-operative urinary retention: a randomized double-blind placebo-controlled study. Int Braz J Urol 40(1):30–36

    Article  Google Scholar 

  12. Shaw MK, Pahari H (2014) The role of peri-operative use of alpha-blocker in preventing lower urinary tract symptoms in high risk patients of urinary retention undergoing inguinal hernia repair in males above 50 years. J Indian Med Assoc 112(1):13–24

    CAS  PubMed  Google Scholar 

  13. Akkoc A, Aydin C, Topaktas R et al (2016) Prophylactic effects of alpha-blockers, Tamsulosin and Alfuzosin, on postoperative urinary retention in male patients undergoing urologic surgery under spinal anaesthesia. Int Braz J Urol 42(3):578–584

    Article  Google Scholar 

  14. Buckley BS, Lapitan MC (2010) Drugs for treatment of urinary retention after surgery in adults. Cochrane Database Syst Rev 10:CD008023

    Google Scholar 

  15. Waddle JP, Evers AS, Piccirillo JF (1998) Postanesthesia care unit length of stay: quantifying and assessing dependent factors. Anesth Analg 87(3):628–633

    CAS  PubMed  Google Scholar 

  16. Patel JA, Kaufman AS, Howard RS et al (2015) Risk factors for urinary retention after laparoscopic inguinal hernia repairs. Surg Endosc 29(11):3140–3145

    Article  Google Scholar 

  17. Koch CA, Grinberg GG, Farley DR (2006) Incidence and risk factors for urinary retention after endoscopic hernia repair. Am J Surg 191(3):381–385

    Article  Google Scholar 

  18. Winslow ER, Quasebarth M, Brunt LM (2004) Perioperative outcomes and complications of open vs laparoscopic extraperitoneal inguinal hernia repair in a mature surgical practice. Surg Endosc 18(2):221–227

    Article  CAS  Google Scholar 

  19. Hudak KE, Frelich MJ, Rettenmaier CR et al (2015) Surgery duration predicts urinary retention after inguinal herniorrhaphy: a single institution review. Surg Endosc 29(11):3246–3250

    Article  Google Scholar 

  20. Petros JG, Bradley TM (1990) Factors influencing postoperative urinary retention in patients undergoing surgery for benign anorectal disease. Am J Surg 159(4):374–376

    Article  CAS  Google Scholar 

  21. Kozol RA, Mason K, Mcgee K (1992) Post-herniorrhaphy urinary retention: a randomized prospective study. J Surg Res 52(2):111–112

    Article  CAS  Google Scholar 

  22. Stallard S, Prescott S (1988) Postoperative urinary retention in general surgical patients. Br J Surg 75(11):1141–1143

    Article  CAS  Google Scholar 

  23. Durant PA, Yaksh TL (1988) Drug effects on urinary bladder tone during spinal morphine-induced inhibition of the micturition reflex in unanesthetized rats. Anesthesiology 68(3):325–334

    Article  CAS  Google Scholar 

  24. Kebapci N, Yenilmez A, Efe B et al (2007) Bladder dysfunction in type 2 diabetic patients. Neurourol Urodyn 26(6):814–819

    Article  Google Scholar 

  25. Petros JG, Rimm EB, Robillard RJ et al (1991) Factors influencing postoperative urinary retention in patients undergoing elective inguinal herniorrhaphy. Am J Surg 161(4):431–433

    Article  CAS  Google Scholar 

Download references

Acknowledgements

Thank you to our family, friends, and colleagues who encourage and support us in our work. Thank you Nancy Hopkins and nursing staff in the Pre-Admissions Testing, Same-Day Surgery holding area, and post-anesthesia care unit for playing a key role in keeping this project afloat. Statistical analysis and interpretation were completed with the assistance of Dr. Joseph Nolan, Dr. Carl Miller and the staff of the Northern Kentucky University Burkardt Consulting Center (Highland Heights, KY).

Author information

Authors and Affiliations

  1. Department of Surgery, Jewish Hospital of Cincinnati, 4777 E Galbraith Rd, Cincinnati, OH, 45236, USA

    Michael L. Caparelli, Alexander Shikhman, Brianne Runyan, Shyam Allamaneni & Scott Hobler

Authors
  1. Michael L. Caparelli
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Alexander Shikhman
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Brianne Runyan
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Shyam Allamaneni
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Scott Hobler
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

MLC, AS, BR, SA and SH contributed to the design, implementation, data collection, interpretation and drafting of this manuscript.

Corresponding author

Correspondence to Michael L. Caparelli.

Ethics declarations

Disclosures

Michael L. Caparelli, Alexander Shikhman, Brianne Runyan, Shyam Allamaneni, Scott Hobler have no conflicts of interest or financial ties to disclose.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional review board (IRB) and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Patients who underwent treatment at our institution initially signed a consent form allowing us to study and publish their clinical outcomes.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Caparelli, M.L., Shikhman, A., Runyan, B. et al. The use of tamsulosin to prevent postoperative urinary retention in laparoscopic inguinal hernia repair: a randomized double-blind placebo-controlled study. Surg Endosc 35, 5538–5545 (2021). https://doi.org/10.1007/s00464-020-08050-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00464-020-08050-0

Keywords

Search

Navigation