The_Stethoscope,_Peru

A 27-year-old woman with a long history of hemorrhoids underwent uncomplicated hemorrhoidectomy today. Her surgical history reveals several cesarean sections. Her family history is unremarkable. Your post-operative instructions include assessment of this patient’s voiding.  What is the main reason to assess this patient’s voiding?

A- Her long history of hemorrhoids may result in voiding problems

B- Her history of several pregnancies may cause urinary retention

C- NPO before and during the surgery could cause retention of urine

D- Urinary retention is a common complication of hemorrhoidectomy




Answer:

Urinary retention occurs in one-third of patients following hemorrhoidectomy. It is mainly caused by postoperative edema of the rectum and also as a side effect of spinal anesthesia.  The scenario does not mention any history of retention following several pregnancies which is rare especially after CS deliveries. The patient should be on fluids before and during surgery which exclude NPO as a reason of voiding problems.