Urinary Retention After Hemorrhoidectomy: Can We Reduce Risk?

Yıl 2022, Cilt: 13 Sayı: 45, 25 - 28, 07.04.2022

Fatih Gokalp , Onur Karslı , Tamer Gülsur

https://doi.org/10.17944/mkutfd.928492

Öz

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.

Anahtar Kelimeler

Hemorrhoidectomy, urinary retention, bladder dysfunction, complications

Destekleyen Kurum

None

Teşekkür

None

Hemoroidektomi Sonrası Üriner Retansiyon: Riski Azaltabilir miyiz?

Öz

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.

Anahtar Kelimeler

Hemoroidektomi, üriner retansiyon, mesane disfonksiyonu, komplikasyonlar

Kaynakça

• Kendirci M, Şahiner İT, Şahiner Y, Güney G. Comparison of effects of vessel-sealing devices and conventional hemorrhoidectomy on postoperative pain and quality of life. Med Sci Monit. 2018;24:2173-9. https://doi.org/10.12659/MSM.909750
• Mounsey AL, Halladay J, Sadiq TS. Hemorrhoids. Am Fam Physician. 2011 Jul;84(2):204-10.
• Hoff SD, Bailey HR, Butts DR, Max E, Smith KW, Zamora LF, et al. Ambulatory surgical hemorrhoidectomy--a solution to postoperative urinary retention? Dis Colon Rectum. 1994 Dec;37(12):1242-4. https://doi.org/10.1007/BF02257789
• Zaheer S, Reilly WT, Pemberton JH, Ilstrup D. Urinary retention after operations for benign anorectal diseases. Dis Colon Rectum. 1998 Jun;41(6):696-704. https://doi.org/10.1007/BF02236255
• Sivasankaran M V., Pham T, Divino CM. Incidence and risk factors for urinary retention following laparoscopic inguinal hernia repair. Am J Surg [Internet]. 2014;207(2):288-92. https://doi.org/10.1016/j.amjsurg.2013.06.005
• Pompeius R. Detrusor inhibition induced from anal region in man. Acta Chir Scand Suppl 1966;361:1–54
• Toyonaga T, Matsushima M, Sogawa N, et al. Postoperative urinary retention after surgery for benign anorectal disease: potential risk factors and strategy for prevention. Int J Colorectal Dis. 2006;21(7):676-682. https://doi.org/10.1007/s00384-005-0077-2
• Bansal H, Jenaw RK, Mandia R, Yadav R. How to do open hemorrhoidectomy under local anesthesia and its comparison with spinal anesthesia. Indian J Surg. 2012 Aug;74(4):330-3. https://doi.org/10.1007/s12262-012-0438-3
• Chik B, Law WL, Choi HK. Urinary retention after haemorrhoidectomy: Impact of stapled haemorrhoidectomy. Asian J Surg. 2006 Oct;29(4):233-7. https://doi.org/10.1016/S1015-9584(09)60094-4
• Drissi F, Gillion J-F, Roquilly A, Luyckx F, Duchalais E. Nationwide Analysis of Urinary Retention Following Inguinal Hernia Repair: Results from the National Prospective Hernia Registry. World J Surg. 2020 Aug;44(8):2638-46. https://doi.org/10.1007/s00268-020-05538-7
• Clancy C, Coffey JC, O'Riordain MG, Burke JP. A meta-analysis of the efficacy of prophylactic alpha-blockade for the prevention of urinary retention following primary unilateral inguinal hernia repair. Am J Surg. 2018 Aug;216(2):337-41. https://doi.org/10.1016/j.amjsurg.2017.02.017
• Kebapci N, Yenilmez A, Efe B, Entok E, Demirustu C. Bladder dysfunction in type 2 diabetic patients. Neurourol Urodyn. 2007;26(6):814-9. https://doi.org/10.1002/nau.20422
• Blair AB, Dwarakanath A, Mehta A, Liang H, Hui X, Wyman C, et al. Postoperative urinary retention after inguinal hernia repair: a single institution experience. Hernia. 2017 Dec;21(6):895-900. https://doi.org/10.1007/s10029-017-1661-4