POSTHERNIOPLASTY URINARY RETENTION - A NONINVASIVE WORK-UP FOR PREDICTION

The prognostic value of various subjective and objective noninvasive u rological parameters was evaluated for their possible role in the pred iction of post-hernioplasty urinary retention. In a prospective study, 35 patients aged 55-85 years without previous micturition complaints or urological surgery were evaluated 1 day prior to inguinal herniopla sty. This included medical history for modified Madsen subjective scor ing profile, physical examination and uro-flowmetry. Bladder capacity, residual urine and prostatic volume were measured by ultrasound. All patients underwent a similar method of hernioplasty, were closely foll owed 48 h postoperatively and any voiding difficulties or urinary rete ntion were noted. Urinary retention occurred in 12 patients. None of t he remaining 23 patients had urination difficulties. Comparing these t wo groups, we concluded that patient age, bladder capacity and prostat ic volume have no prognostic value for potential postoperative urinary obstruction. On the other hand, obtaining a good anamnesis of obstruc tive and irritative symptoms for scoring, measuring maximal flow rate on urinary flowmetry and estimating residual urine volume may predict patients who are potentially at high risk for posthernioplasty urinary retention.