Prophylactic effect of Tamsulosin on postoperative urinary retention in Inguinal hernia repair under spinal anesthesia

Background and purpose: Inguinal hernioplasty is a common surgical procedure, often associated with complications such as post-operative urinary retention (POUR). POUR, characterized by an inability to urinate despite a full bladder following a surgery that may need foley catheterization that on its own can lead to urinary tract infection, stricture, prolonged hospitalization, and increases cost of hospital care. Tamsulosin is a selective alpha-1 adrenergic blocker that can increase urine flow by relaxing the smooth muscle of urethra and prostate, thereby as a less invasive method may be effective in prevention of POUR. Materials and methods: This randomized clinical trial involved 179 male participants over 50 undergoing unilateral hernioplasty under spinal anesthesia. Group A (87 subjects) received 0.4 mg Tamsulosin 8 h before surgery, then 6-12 h post-operatively. Group B (92 subjects) received a placebo on the same schedule. Both were monitored for POUR incidence within 24 h post-surgery. Data were analyzed using SPSS software version 18 and the P < 0.05 was considered statistically significant. Results: The mean age of participants was 63.37 +/- 10.62 years. POUR requiring catheterization occurred in 10.3 % of Group A and 16.3 % of Group B. However, the difference was not statistically significant (p = 0.242). Logistic regression showed no significant prophylactic effect of Tamsulosin (p = 0.171), hypertension (p = 0.166), diabetes mellitus (p = 0.196), or benign prostatic hyperplasia (p = 0.273) on POUR incidence. Conclusion: Prophylactic Tamsulosin did not significantly reduce the incidence of POUR following inguinal hernioplasty under spinal anesthesia.