Postoperative urinary retention after gynecologic surgery or hysterectomy is commonly found. It was reported range from 4-8%. The diagnostic criteria used to define retention varies among each literature and type of anesthesia also affect the retention of urine, Moreover, the incidence varies among hysterectomy route. There were 4-13.7% for abdominal hysterectomy, 12-15% for vaginal hysterectomy and 7% for laparoscopic hysterectomy.[1]  Inappropriate management of postoperative urinary retention may lead to bladder overdistention causes permanent detrusor injury, urinary tract infection and catheter-related complications.[2] Prolong length of hospital stay, distressing and increasing the cost in the hospital are the consequence of postoperative urinary retention.[3] 
The aim of the study to evaluate the prevalence of postoperative urinary retention after laparoscopic hysterectomy and risk factors associated with urinary retention.

This was a retrospective descriptive study. After ethics committee was approved, the medical records were reviewed all patients who have undergone laparoscopic hysterectomy in tertiary hospital from January 2016 to December 2019. Patient characteristics, the indication for hysterectomy, the perioperative outcomes, perioperative complications and postoperative complications were recorded. Postoperative overt urinary retention is defined as the inability to urinate requiring urinary straight or indwelling catheterization after the day of surgery.
Statistical analysis was performed using STATA/SE version 10.1. Normality testing was conducted using Kolmogorov-Smirnov testing. The descriptive data were presented as percentages, means, and medians. The t-test, Chi-square and Fisher’s exact test were used as appropriate to evaluate factors associated with urinary retention. p-values of <0.05 were considered statistical significance.

A total of 164 patients underwent laparoscopic hysterectomy for benign gynecologic diseases. The mean age + SD and BMI were 44.3 + 13.4 years and 24.0 + 4.2 kg/m2, respectively. Thirty-three patients were in menopausal status (20.1%). No one had history of smoking. Ninety-two patients (56.1%) had history of abdominal surgery.
Regarding lower urinary tract symptoms (LUTs), urinary frequency (15.9%) was the most common abnormality symptoms and followed by stress urinary incontinence (5.5%), voiding dysfunction (3.7%) and urgency urinary incontinence (2.4%).
Laparoscopic total hysterectomy was operated in 152 patients (92.7%). While the remaining (7.3%) were performed laparoscopic subtotal hysterectomy. Pelvic adhesion was detected 29.3%.
The median amount of intraoperative blood loss was 100ml (50, 150). The median of operative time and median of postoperative hospital stay were 143 minutes (110.7, 180) and 3 days (2, 3).
Perioperative complications were detected 12 patients (7.3%) included intestinal injury (3.0%), bladder injury (0.6%) and ureteric injury (0.6%). Five patients (3.0%) required intraoperative blood transfusion. 
Postoperative overt urinary retention was detected one patient (0.6%) after removed catheterization the day after surgery. This patient suffered from paraplegia and neurogenic bladder.
Other postoperative complications such as surgical site infection (0.6%), postoperative fever (1.8%), urinary tract infection (0.6%) and reoperation (0.6%)

The incidence of overt urinary retention was low. It was detected 0.6% after laparoscopic hysterectomy.

The incidence of postoperative overt urinary retention is very low after laparoscopic hysterectomy in benign gynecologic disease. It should be caution in case suspected neurogenic problems.

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Baldini G, Bagry H, Aprikian A, Carli F. Postoperative urinary retention: anesthetic and perioperative considerations. Anesthesiology. 2009;110:1139–57.
Ghezzi F, Cromi A, Uccella S, Colombo G, Salvatore S, Tomera S, et al. Immediate Foley removal after laparoscopic and vaginal hysterectomy: determinants of postoperative urinary retention. J Minim Invasive Gynecol. 2007;14:706–11.