title: Epidural anesthesia does not increase the incidences of urinary retention and hesitancy in micturition after ambulatory hemorrhoidectomy.
abstract: BACKGROUND
  This randomized, prospective study was designed to evaluate the role of various anesthesias in postoperative urinary retention and hesitancy in micturition in patients receiving hemorrhoidectomy on ambulatory basis.
  
  
  METHODS
  In a randomized order, 128 ambulatory patients, ASA physical status I or II, were divided into two groups to receive hemorrhoidectomy under epidural or local anesthesia. In all patients, the intraoperative intravenous fluid given was limited to 200 ml +/- 2 ml/kg/h of Ringer's lactate solution. Patients were requested to void urine voluntarily before discharge. The incidences of postoperative urinary retention and hesitancy in micturition were evaluated by telephone interview 24 hours after surgery.
  
  
  RESULTS
  Neither the incidence of urinary retention, nor the incidence of hesitancy in micturition was significantly different between the two groups. Patients with age over 50 had a significantly higher incidence of hesitancy in micturition than younger patients. The incidence of hesitancy in micturition seemed higher in male patients (31.3%) than that in females (15.6%), but the difference was not statistically different (P = 0.0585).
  
  
  CONCLUSIONS
  With judicious intraoperative fluid restriction and voluntary voiding before discharge, epidural anesthesia does not increase the incidence of postoperative urinary retention or hesitancy in micturition following ambulatory hemorrhoidectomy.
authors.affiliation: Department of Anesthesiology, Chang Gung Memorial Hospital, 5 Fu-Shin Street, Kweishan, Taoyuan, Taiwan, R.O.C.
authors.forename: Yi-Chuan
authors.initials: YC
authors.lastname: Kau
authors.forename: Yu-Hao
authors.initials: YH
authors.lastname: Lee
authors.forename: Jihn-Yih
authors.initials: JY
authors.lastname: Li
authors.forename: Chit
authors.initials: C
authors.lastname: Chen
authors.forename: Shu-Yam
authors.initials: SY
authors.lastname: Wong
authors.forename: Teresa Kit-Man
authors.initials: TK
authors.lastname: Wong
mesh_terms: D000328:Adult; D000556:Ambulatory Surgical Procedures; D000767:Anesthesia, Epidural / Q000009:adverse effects*; D000772:Anesthesia, Local; D005260:Female; D006484:Hemorrhoids / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D016055:Urinary Retention / Q000139:chemically induced*; D014555:Urination Disorders / Q000139:chemically induced*