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Laproscopic without catheter or open with mesh
Some may disagree with my opinion, but I have specifically asked urologists this same question and also seen complications related to the bladder. So here it is:
1. I do not ever recommend any laparoscopic pelvic surgery (appendix, inguinal hernias, lower abdominal incisional hernias) to be performed without decompressing the bladder with a catheter. Why?
– there is a risk of injuring the bladder
– even with urinating prior to surgery, some people may not completely empty their bladder, thus injury to the bladder.
– I have seen multiple complications, such as tacking the mesh to the bladder, or laying the mesh onto the bladder thus resulting in bladder spasms, pain with filling of the bladder, and resultant urinary frequency.I do combined procedures with prominent urologists in our town. They are very concerned that it is common practice for general surgeons to perform laparoscopic inguinal hernia repair without catheter.
2. Open repair is a valid option, as urinating prior to repair and restricting IV fluids is typically enough to prevent need for catheterization.