A meta-analysis of the efficacy of prophylactic alpha-blockade for the prevention of urinary retention following primary unilateral inguinal hernia repair.
Urinary retention following inguinal hernia surgery is common and is believed to be associated with adrenergic over-stimulation of the smooth muscle in the bladder neck and prostate. The efficacy of prophylactic alpha-blockade in the prevention of urinary retention following elective inguinal hernia repair in males is unknown.



A comprehensive literature search was performed adhering to PRISMA guidelines. Each study was reviewed and data were extracted. Random-effects models were used to combine data.



Five randomized studies describing 456 patients were identified. General or spinal anaesthetic were used. Prophylactic alpha-blockade decreases the risk of urinary retention requiring catheterisation following elective unilateral inguinal hernia repair compared to control groups (OR:0.179, 95% CI:0.043-0.747, p:0.018). Rates of urinary retention between treatment and control groups are reduced by 20.6%. No serious complications relating to alpha blockade occurred.



Prophylactic alpha-blockade reduces urinary retention following elective inguinal hernia surgery under general or spinal anaesthetic.
Department of Colorectal Surgery, Beaumont Hospital, Dublin 9, Ireland.
C
C
Clancy
Department of Colorectal Surgery, University Hospital Limerick, Limerick, Ireland.
J C
JC
Coffey
Department of Colorectal Surgery, Mercy University Hospital, Cork, Ireland.
M G
MG
O'Riordain
Department of Colorectal Surgery, Beaumont Hospital, Dublin 9, Ireland. Electronic address: johnburke@rcsi.ie.
J P
JP
Burke
D000317:Adrenergic alpha-Antagonists / Q000627:therapeutic use*; D006552:Hernia, Inguinal / Q000601:surgery*; D059685:Herniorrhaphy / Q000009:adverse effects*; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control*; D016896:Treatment Outcome; D016055:Urinary Retention / Q000209:etiology / Q000517:prevention & control*
D000317:Adrenergic alpha-Antagonists
Alpha blockers; Inguinal hernia; Urinary retention