WP1.1 - Examining the effectiveness of prescribing Tamsulosin before elective surgery for inguino-scrotal hernias - a case series Free

Urinary retention following surgery is a common issue that can result in significant morbidity and prolonged hospital admissions. Tamsulosin is commonly used to manage patients at risk of urinary retention in the community but its usefulness at preventing retention following surgery is currently unclear. This case series describes the effectiveness of using short courses of tamsulosin to prevent post-operative urinary retention at a single centre.

Males aged over 70 who underwent elective surgery for an inguino-scrotal hernia between January 2022 and January 2024 were included in this series. Inclusion also required the patients to be planned as day case procedures under general anaesthetic. Patients with a known history of prostatic disease and/or who were already taking Tamsulosin or another alpha-1 adrenoceptor inhibitor were excluded.

67 patients who took 400 micrograms of Tamsulosin once daily for 2 days before and on the day of surgery were included in this series. The patients were aged between 70 - 89 years and all underwent elective open mesh hernia repairs under the same surgeon with the same materials. None of the patients suffered post-operative urinary retention and so were able to be discharged as day cases.

The absence of any instances of post-operative urinary retention in this series suggests that a course of Tamsulosin before elective inguino-scrotal hernia repair can effective as prophylaxis against the condition. This data alongside additional randomised control trials demonstrating the benefits of pre-operative Tamsulosin may result in it being used more widely.