EFFECTIVENESS OF DICLOFENAC SUPPOSITORY AS AN ANALGESIC IN REDUCING POST-OPERATIVE URINARY RETENTION AFTER INGUINAL HERNIA REPAIR
Authors: Basith P.T Abdul , Krishnaprasad Krishnaprasad 
Published: December 2024

Background:Inguinal hernia repair is a common surgical procedure associated with various postoperative complications, including postoperative urinary retention (POUR). The incidence of POUR varies significantly, affecting up to 22% of patients. This complication can prolong hospital stay, increase patient discomfort, and result in additional medical interventions. Diclofenac, a non-steroidal anti-inflammatory drug (NSAID), is often used for pain relief and has been hypothesized to reduce the incidence of POUR by alleviating postoperative pain and sympathetic nervous system stimulation. This study aimed to assess the efficacy of diclofenac suppository in preventing POUR following inguinal hernia repair.

Objectives:The primary objective of this study was to evaluate whether the use of diclofenac suppositories reduces the incidence of postoperative urinary retention in patients undergoing inguinal hernia repair.

Methods:A prospective cohort study was conducted at the Government Medical College Kozhikode, including 108 patients undergoing elective unilateral inguinal hernia repair under local or spinal anesthesia. Patients were randomly divided into two groups: one group received diclofenac suppositories postoperatively, while the other did not. The incidence of POUR was the primary outcome measure, and patients were monitored for urinary retention post-surgery. Data were collected and analyzed using SPSS software, employing Chi-square tests to determine statistical significance.

Results:Out of 108 patients, 10 experienced postoperative urinary retention, with 4 (7.4%) from the diclofenac suppository group and 6 (11.1%) from the non-diclofenac group. The analysis revealed no statistically significant difference in the incidence of POUR between the two groups (p-value = 0.506). The lack of significance might be attributed to the relatively small sample size or other confounding factors.

Conclusions:The study concluded that the use of diclofenac suppositories does not significantly reduce the incidence of postoperative urinary retention in patients undergoing inguinal hernia repair. While a trend towards lower incidence was observed in the diclofenac group, the difference was not statistically significant. The results indicate that factors such as sample size, patient selection, and anesthesia type may influence outcomes, and further research with larger populations is warranted to confirm these findings.

Implications: The findings suggest that diclofenac suppositories may not be effective in preventing postoperative urinary retention in inguinal hernia repair, highlighting the need for alternative strategies and further investigation into perioperative management practices to mitigate this complication. Future studies should focus on larger sample sizes and consider additional variables that may affect POUR incidence.

Discussion:The present study which was done on 108 patients who underwent unilateral inguinal hernia repair under local or spinal anesthesia was completed within stipulated time and the data collected were entered and analyzed using SPSS software and the results were tabulated as below.