The use of tamsulosin to prevent postoperative urinary retention in laparoscopic inguinal hernia repair: a randomized do
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and Other Interventional Techniques
The use of tamsulosin to prevent postoperative urinary retention in laparoscopic inguinal hernia repair: a randomized double‑blind placebo‑controlled study Michael L. Caparelli1 · Alexander Shikhman1 · Brianne Runyan1 · Shyam Allamaneni1 · Scott Hobler1 Received: 15 June 2020 / Accepted: 26 September 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose The rate of postoperative urinary retention (POUR) in laparoscopic inguinal hernia repairs is 1–22%. POUR may cause patient anxiety, discomfort, and increased hospital costs. Currently there is no standard prophylaxis for POUR. Preoperative administration of tamsulosin has been shown to decrease POUR rates in urologic studies. This study aims to evaluate the efficacy of tamsulosin on the incidence of POUR in patients undergoing totally extraperitoneal (TEP) LIHR. Methods A randomized, double-blinded, placebo-controlled trial was initiated and accrued patients from 2017 to 2019. A total of 169 males undergoing elective TEP LIHR were included. Patients were administered tamsulosin 2 h before surgery and followed for up to 24 h postoperatively for episodes of POUR. Analysis was performed to quantify the association between patient, surgical, and perioperative factors with POUR. Results The overall rate of POUR was 9%. There was no difference in the rate of POUR between the placebo (9.9%) and tamsulosin groups (7.9%) (p = 0.433). Univariate analysis showed a trend toward POUR in patients with history of benign prostatic hypertrophy (BPH) (p = 0.058). Previously reported risk factors of older age, total IVF, length of procedure and opioid use were not associated with increased rates of POUR. Tamsulosin reduced the time to discharge by 4 to 68 min when compared to placebo. Conclusions This study suggests that preoperative administration of tamsulosin may not reduce the risk of POUR in males undergoing elective TEP LIHR. Further study with a larger sample size may be needed to show a statistically significant difference. Keywords Laparoscopic inguinal hernia repair · Tamsulosin · Postoperative urinary retention Inguinal hernia repair is one of the most commonly performed general surgery operations. There are approximately 800,000 repairs done in the United States every year [1]. Inguinal hernia repair may be performed in an open or laparoscopic fashion and has been shown to have similar results. The two most common laparoscopic repairs are totally extraperitoneal (TEP) and transabdominal preperitoneal (TAPP) and are considered tension free [2]. Hernia repair is generally well tolerated by patients and thought of as an outpatient procedure with low morbidity. One common complication of all surgeries is postoperative urinary retention (POUR), * Michael L. Caparelli [email protected] 1
Department of Surgery, Jewish Hospital of Cincinnati, 4777 E Galbraith Rd, Cincinnati, OH 45236, USA
which occurs in up to 5–70% of patients [3]. In the current literature the rate of POUR in laparoscopic
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