Do Urinary Catheters prevent Urinary Retention after Hernia Surgery?

If you're scheduled for an inguinal hernia repair, you may be wondering about the various techniques and the potential risks and complications.

One particularly common complication is post-surgical urinary retention. This can be a painful and distressing event that can negatively affect the patient’s satisfaction.

Urinary catheters are frequently used to prevent postoperative urinary retention (POUR).
Recently, a clinical trial was conducted to assess the effectiveness of using urinary catheters during hernia surgery to prevent the occurrence of postoperative urinary retention.

Postoperative urinary retention is a common complication of many surgical procedures, particularly those involving the lower abdomen and pelvis. It occurs when the urinary bladder is unable to empty fully, either due to swelling or muscle weakness. Symptoms can include discomfort or pain in the lower abdomen, a feeling of pressure or fullness in the bladder, and the inability to urinate even when the bladder is full.

Urinary catheters are commonly placed during laparoscopic inguinal hernia surgery to prevent the blockage of urine after the procedure however, strong clinical data to justify this practice is lacking.

A recent clinical study published in the Journal of the American Medical Association (JAMA) has shed some light on the effectiveness of using urinary catheters during hernia surgery to prevent urinary retention postoperatively.

The clinical trial was conducted across 6 hospitals in the United States. It included 491 patients who were divided into two groups. In 241 patients, a urinary catheter was passed at the beginning of the surgery and removed at the end of the procedure. No catheter was passed in the remaining 250 patients. 

After the surgery, the researchers monitored the patients for urinary retention, defined as the inability to urinate spontaneously within six hours of surgery.

Overall 44 patients developed urinary retention. Of these, 23 patients (9.6%) belonged to the catheter group while 21 patients (8.5%) belonged to the group that did not receive urinary catheters.

The results of this clinical trial indicate that there is no significant difference in the risk of developing postoperative urinary retention between the two groups. Hence, urinary catheters did not reduce the risk of urinary blockage in these patients undergoing hernia surgery while it did increase the risk of catheter-related complications such as bleeding and damage to the urethra.

This clinical study provides valuable insights into the potential risks and benefits of urinary catheterization during surgery.

This clinical trial has important implications for the management of hernia surgery patients as it proves that urinary catheters provide no benefit in reducing urinary retention episodes after surgery and their use should be avoided.

In conclusion, if you are undergoing inguinal hernia surgery, using a urinary catheter during the procedure will not help in preventing urinary retention later on. It is important to discuss all options with your surgeon before surgery to make an informed choice.
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