Postherniorrhaphy urinary retention--effect of local, regional, and general anesthesia: a review.
OBJECTIVE
Postherniorrhaphy urinary retention (UR) may depend on the anesthetic technique. We therefore reviewed available published studies of UR in relation to anesthetic technique.


METHODS
A Medline-based search (1966-November 2001) revealed 70 nonrandomized and 2 randomized studies.


RESULTS
The incidence of UR was lower with local anesthesia (LA) (33 in 8991 patients, 0.37%, 95% confidence interval [CI] 0.24%-0.49%) compared with regional anesthesia (RA) (150 in 6191 patients, 2.42%, 95% CI 2.04%-2.81%) and general anesthesia (GA) (344 in 11471 patients, 3.00%, 95% CI 2.69%-3.31%).


CONCLUSIONS
The low incidence of UR with LA is in accordance with the inhibitory effects of RA and GA on bladder function. Data from newer short-acting techniques of GA and RA are required to define the optimal anesthetic for inguinal herniorrhaphy.
Jensen
Peter
P
Department of Surgical Gastroenterology 435, University of Copenhagen, Hvidovre Hospital, Hvidovre, Denmark.
Mikkelsen
Trine
T
Kehlet
Henrik
H
D000758:Anesthesia / Q000009:adverse effects* / Q000379:methods; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D015994:Incidence; D011183:Postoperative Complications; D016032:Randomized Controlled Trials as Topic; D016055:Urinary Retention / Q000209:etiology*