title: Surgery duration predicts urinary retention after inguinal herniorrhaphy: a single institution review.
abstract: BACKGROUND
  Inguinal hernia repair, laparoscopic or open, is one of the most frequently performed operations in general surgery. Postoperative urinary retention (POUR) can occur in 0.2-35 % of patients after inguinal hernia repair. The primary objective of this study was to determine the incidence of POUR after inguinal hernia repair. As a secondary goal, we sought to determine whether perioperative and patient factors predicted urinary retention.
  
  
  METHODS
  This study is a retrospective review of patients who underwent inguinal hernia repair with synthetic mesh at the Medical College of Wisconsin from January 2007 to June 2012. Procedures were performed by four surgeons. Clinical information and perioperative outcomes were collected up to hospital discharge. Urinary retention was defined as need for urinary catheterization postoperatively.
  
  
  RESULTS
  A total of 192 patients were included in the study (88 bilateral, 46 %) and (104 unilateral, 54 %). The majority of subjects (76 %) underwent laparoscopic repair. The overall POUR rate was 13 %, with 25 of 192 patients requiring a Foley catheter prior to discharge. POUR was significantly associated with bilateral hernia repairs (p = 0.04), BMI ≥ 35 kg/m(2) (p = 0.05) and longer operative times (p = 0.03). Based on odds ratio (OR) estimates, for every 10-min increase in operative time, an 11 % increase in the odds of urinary retention is expected (OR 1.11, CI 1.004-1.223; p = 0.04). For every 10-min increase in operative time, an 11 % increase in POUR is expected.
  
  
  CONCLUSIONS
  Bilateral hernia repairs, BMI ≥ 35 kg/m(2), and operative time are significant predictors of POUR. These factors are important to determine potential risk to patients and interventions such as strict fluid administration, use of catheters, and potential premedication.
authors.affiliation: Division of General Surgery, Department of Surgery, Medical College of Wisconsin, 9200 W. Wisconsin Ave., Milwaukee, WI, 53226, USA.
authors.forename: Kevin E
authors.initials: KE
authors.lastname: Hudak
authors.affiliation: Division of General Surgery, Department of Surgery, Medical College of Wisconsin, 9200 W. Wisconsin Ave., Milwaukee, WI, 53226, USA.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Frelich
authors.affiliation: Division of General Surgery, Department of Surgery, Medical College of Wisconsin, 9200 W. Wisconsin Ave., Milwaukee, WI, 53226, USA.
authors.forename: Chris R
authors.initials: CR
authors.lastname: Rettenmaier
authors.affiliation: Division of Biostatistics, Institute for Health and Society, Medical College of Wisconsin, 9200 W. Wisconsin Ave., Milwaukee, WI, 53226, USA.
authors.forename: Qun
authors.initials: Q
authors.lastname: Xiang
authors.affiliation: Division of General Surgery, Department of Surgery, Medical College of Wisconsin, 9200 W. Wisconsin Ave., Milwaukee, WI, 53226, USA.
authors.forename: James R
authors.initials: JR
authors.lastname: Wallace
authors.affiliation: Division of General Surgery, Department of Surgery, Medical College of Wisconsin, 9200 W. Wisconsin Ave., Milwaukee, WI, 53226, USA.
authors.forename: Andrew S
authors.initials: AS
authors.lastname: Kastenmeier
authors.affiliation: Division of General Surgery, Department of Surgery, Medical College of Wisconsin, 9200 W. Wisconsin Ave., Milwaukee, WI, 53226, USA.
authors.forename: Jon C
authors.initials: JC
authors.lastname: Gould
authors.affiliation: Division of General Surgery, Department of Surgery, Medical College of Wisconsin, 9200 W. Wisconsin Ave., Milwaukee, WI, 53226, USA. mgoldbla@mcw.edu.
authors.forename: Matthew I
authors.initials: MI
authors.lastname: Goldblatt
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006552:Hernia, Inguinal / Q000601:surgery*; D059685:Herniorrhaphy / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D010535:Laparoscopy / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology; D011379:Prognosis; D012189:Retrospective Studies; D016055:Urinary Retention / Q000453:epidemiology* / Q000209:etiology; D014922:Wisconsin / Q000453:epidemiology; D055815:Young Adult
keywords: Inguinal hernia; Operative time; Urinary retention