Hemoroidektomi Sonrası Üriner Retansiyon: Riski Azaltabilir miyiz?

Abstract

Amaç: Hemoroidektomi sık uygulanan bir ameliyattır ve anorektal ameliyatlar sonrası üriner retansiyon (ÜR) istenmeyen bir komplikasyondur. Bu çalışmada hemoroidektomi sonrası ÜR riskini araştırmayı ve ÜR ile ilişkili faktörleri tahmin etmeyi amaçladık. Yöntemler: 2016-2018 yılları arasında genel anestezi ile hemoroidektomi yapılan 180 hasta çalışmaya dahil edildi. Daha önce ürolojik semptomları ve ürolojik cerrahisi olan hastalar çalışma dışı bırakıldı. Bulgular: Hastaların medyan yaşı 45,5 (IQR: 40,0-55,0) yıl idi. Hastaların 116 (%64,4) erkek ve 64 (%35,6) kadındı. İdrar retansiyonu erkeklerde anlamlı olarak daha yüksek görüldü (p=0,03) ancak Vizual ağrı skalası (VAS) ve analjezik ihtiyacı erkekler ve kadınlar arasında benzerdi (sırasıyla p = 0,39 ve p = 0,86). Regresyon analizi, erkek cinsiyet, ameliyat süresi ve analjezik gereksiniminin ÜR ile ilişkili olmadığını ve VAS'ın UR için tek prediktif faktör olduğunu gösterdi (OR: 0.224, p<0.001). Sonuç: UR, sık görülen ve endişe verici bir komplikasyondur. VAS, üriner retansiyon için önemli öngörü faktörüdür. Yeterli analjezi, bu komplikasyonu önlemenin anahtarı olabilir.

Keywords

• Hemoroidektomi
• üriner retansiyon
• mesane disfonksiyonu
• komplikasyonlar

Urinary Retention After Hemorrhoidectomy: Can We Reduce Risk?

Abstract

Objectives: Hemorrhoidectomy is a common surgery and urinary retention (UR) after anorectal surgeries is an unwelcome complication. In this study we aimed to investigate risk of UR after hemorrhoidectomy and predict the factors associated with UR. Methods: Between 2016-2018 years, 180 patients who undergone hemorrhoidectomy by general anesthesia were included study. The patients with urological symptoms and urological surgery before were excluded. Results: Median age of patients was 45.5 (IQR: 40.0-55.0) years. There was 116 (64.4%) of male and 64 (35.6%) of woman. Urinary retention was seen significantly higher in men (p=0.03) but, visual pain scale (VPS) and the analgesic requirement were similar between men and women (p=0.39 and p=0.86, respectively). Regression analysis showed that male gender, operation time and analgesic requirement was not associated UR and the VPS is only predictive factor for UR (OR:0.224, p<0.001). Conclusion: The UR is an often and worrisome complication. The VPS is the important predictive factor for urinary retention. The sufficient analgesia could be the key to prevent this complication.

Keywords

• Hemorrhoidectomy
• urinary retention
• bladder dysfunction
• complications

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