ReviewSurgical endoscopy2025
Sugammadex reduces urinary retention after laparoscopic inguinal hernia repair: a retrospective analysis and brief literature review.
Review in Surgical endoscopy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
1 citing paper in PubMed.
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionPostoperative urinary retention (POUR) is common after inguinal hernia repairs (IHR). General anesthesia often utilizes paralytic agents such as vecuronium and rocuronium, which are subsequently reversed with neostigmine upon surgery completion. Neostigmine has undesired cholinergic effects, however, and is typically co-administered with glycopyrrolate, an anticholinergic agent which can impair bladder contraction, leading to urinary retention. Early studies have investigated sugammadex, an alternative reversal agent without cholinergic properties, to reduce POUR after IHR, yet none have focused on an exclusively laparoscopic cohort.
methodsThis retrospective cohort study included adult male patients who underwent elective laparoscopic IHR procedures performed by a single surgeon from October 2021 to June 2024. Patients were divided into two groups: neostigmine/glycopyrrolate (NG-G) vs. sugammadex (SG). POUR rates and secondary outcomes were compared.
resultsOf the total n = 228 patients, NG-G included n = 122 and SG n = 106. Median age was 61.6 years. Procedures were predominantly totally extraperitoneal (92.5%). Age, prostate disease history, International Prostate Symptom Scores, anesthesia/operative times, intraoperative/PACU opioid use, steroid use, and anticholinergic use were similar between groups (p > 0.05). NG-G patients received more intravenous fluids, but still < 500 mL (375 vs. 250 mL, p < 0.01). Twelve patients (9.8%) in the NG-G cohort experienced POUR versus none in SG (p < 0.01). Urinary symptoms were reported in 19.7% of NG-G cases and 0% of SG (p < 0.01). Post-void residual volumes were lower in the SG group (median 9 vs 136 mL, p < 0.01). The SG cohort had shorter recovery times (191.5 vs 306.0 min, p < 0.01). There were 2 readmissions for NG-G cases, both for urinary retention, and none in SG (p = 0.19).
conclusionsPatients who received sugammadex compared to neostigmine/glycopyrrolate had lower rates of POUR and shorter recovery times, suggesting that sugammadex should be the routine reversal agent in laparoscopic IHR, especially in older men with prostate disease at increased risk of retention.
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