Page 62 - International guidelines for groin hernia management

Hernia

The medical literature strongly supports the advantages urinary and sexual dysfunction, hematoma, seroma, infre-
of elective laparoscopic femoral hernia repair. 10 Three quent visceral and vascular injuries, late postoperative
cohort studies from specialized hernia centers found that complications, and mortality. These secondary measures
endoscopic repairs provide the opportunity to unerringly are indispensable when considering the success and value
diagnose conditions which may have been obscure preop- of different types of IH repairs. Only these are reported in
eratively. 7, 14, 15 Several other cohort studies of various this chapter.
sizes found significantly fewer recurrences after elective Urinary retention
endoscopic femoral hernia repairs compared to
open. 8, 10, 33 The aforementioned arguments strongly sup- Key questions
port a laparoendoscopic approach for femoral hernia repair.
KQ18.a Is early postoperative pain associated with
Chapter 18 increased urinary retention risk?
KQ18.b Is there an age-associated postoperative urinary
retention risk?
Complications: prevention and treatment KQ18.c Does intraoperative parenteral fluid restriction
reduce urinary retention risk?
S. Smedberg, W. Reinpold, A. Wijsmuller, and R. KQ18.d Is there an increased risk of postoperative urinary
Fitzgibbons retention with open anterior repair?
KQ18.e When is prophylactic urinary bladder catheteri-
Introduction zation indicated before hernia operation?
Common primary outcome measures in IH surgery studies KQ18.f Is there effective prophylactic medication to
include: recurrence, chronic postoperative pain, and wound decrease urinary retention?
infection. Usually reported as secondary outcomes are:

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