Inguinal hernia repair and urinary retention

Resolved question:
I am a 66 year old male, very fit, and a competitive runner, I have a right inguinal hernia with a bulge smaller than an egg, not large at all, reducible, minimal discomfort, I have cut back on fast running, do walking and stationary bike, I have an appointment with a reputable surgeon in 4 weeks. The problem is I'm driving myself literally crazy by studying hernai repair on-line, I've read some horror stories, I've found out that inquinal hernia repair is very safe and is on an out patient basis. One thing that concerns me and is causing me to lose sleep is urinary retention post surgery. I have mild BPH like most middle aged men, no major symptoms other than sometimes not emptying bladder and change of weather (cold) affects me, I've read that 25% of men over 60 undergoing this surgery have UR. Would a beta blocker or another type of drug be given pre-op to avoid this, or am i just letting my mind and researching run away with itself? If you could shed some light on this and perhaps allay my fears, I'd be most greatful.

Submitted: 4 Days
Category: General Surgeon

Expert:  Dr. Hari Charan Perigela replied 4 Days.

Hello,

Thank you for choosing DoctorSpirng.

Hernia Surgery is one of the most commonly preformed surgery. It is generally very safe procedure.
You taken the "25%" figure out of context. This urinary retention mentioned here is NOT a permanent urinary retention. This retention is mainly due to the spinal anaesthesia, not the surgery per se. So any Surgery under spinal anaesthesia can have urinary retention because the nerves controlling the bladder will be temporarily paralysed for the surgery.

I would not even call it as a complication. Its more like effect of the Anaesthesia. Mild BPH should not be factor here. Most centres catheterise the patients just before the surgery to avoid urinary retention.

Do not worry. Don't get misguided by the half truths you read on the internet.

Please feel free to ask followups.
Thank you

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Patient replied :

his urinary retention mentioned here is NOT a permanent urinary retention. This retention is mainly due to the spinal anaesthesia, not the surgery per se.
Thank you doctor for your reply; your answer makes me feel better, I am electing to have open hernia surgery with LOCAL anaesthesia, will the hospital still catheterise before surgery? I've got to stay off the internet, half truths are correct. I believe Laprocscopy is not done under GENERAL anaethesia is that correct? Thank you and will await your reply, if there is anything else I need to know please advise.


Expert:  Dr. Hari Charan Perigela replied 3 Days.

Hello,

The decision of catheterisation and the type of Anaesthesia is actually depended on the Institution Policy and the Operating Surgeons preference.

We do catheterise most patients above 60 years of age.
Laparoscopic inguinal hernia can be done under Spinal or General anaesthesia.

I recommend you to discuss these options when you meet your Surgeon.

Hope this helps
Feel free to ask followups.

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Patient replied :

Doctor, can't thank u enough; since I'm active, can I jog easily until my surgery and wear compression shorts, or just stick to stationary biking and power walking for now? Also, I have been icing the small bulge EVERY day is that a good idea to help relieve any discomfort?


Expert:  Dr. Hari Charan Perigela replied 2 Days.

Hi,

It is better for you not to take up any physical activity,even with compression shorts. I advice the same to my patients too.

Sometimes,the bowel that is present inside the hernial sac can become irreducible/obstructed/strangulated. Ice packs will not be helpful.

It is better to go for surgery as early as possible.
Regards

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Patient replied :

Thanks again Doctor; so please let's sum up; BPH should be no problem with the inguinal surgery, the surgery should be relatively easy and post op should be not be a major problem? Is this all correct?


Expert:  Dr. Hari Charan Perigela replied 1 Day.

Exactly, no need for any worry. ! All the best for the surgery and wish you speedy recovery

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