{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T18:44:23Z","timestamp":1763145863945,"version":"3.45.0"},"reference-count":25,"publisher":"Public Library of Science (PLoS)","issue":"11","license":[{"start":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T00:00:00Z","timestamp":1763078400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>This study aimed to determine whether sugammadex use is associated with lower postoperative urinary retention (POUR) incidence than neostigmine-glycopyrrolate reversal in patients undergoing laparoscopic hernia repair.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cohort study used the TriNetX research network database to analyze adult patients who underwent laparoscopic hernia repair. Patients receiving rocuronium\/vecuronium were divided into sugammadex (n\u2009=\u200992,543) or neostigmine-glycopyrrolate (n\u2009=\u200911,723) reversal groups. After 1:1 propensity score matching, 11,722 matched pairs were analyzed. The primary outcome was POUR within 30 days. The secondary outcomes included pneumonia, hospital readmission, and emergency department (ED) visits. Subgroup analyses were used to examine the effects of age and sex.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In the matched cohort (n\u2009=\u200923,444), sugammadex was associated with a significantly lower risk of POUR (OR 0.23, 95% CI 0.18\u20130.31; p\u2009&lt;\u20090.001) and ED visits (OR 0.76, 95% CI 0.66\u20130.87; p\u2009&lt;\u20090.001). No significant differences were found in pneumonia or readmission rates. The POUR reduction was consistent across sexes (males: OR 0.32; females: OR 0.33) but more pronounced in patients aged &gt;50 years (OR 0.35) than in younger patients (OR 0.50, p\u2009=\u20090.067). Among male patients receiving sugammadex, older age (OR, 1.01), history of urinary retention (OR, 9.94), and benign prostatic hyperplasia (OR, 4.04) were significant independent risk factors for POUR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Sugammadex use is associated with a 77% reduction in POUR and 24% fewer ED visits than neostigmine following hernia repair, suggesting that it may be the preferred reversal agent, particularly for older adults who gain the most benefit.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0335677","type":"journal-article","created":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T18:39:53Z","timestamp":1763145593000},"page":"e0335677","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Risk of postoperative urinary retention after sugammadex use in laparoscopic hernia repair: A matched cohort study of 23,444 cases"],"prefix":"10.1371","volume":"20","author":[{"given":"Kuo-Chuan","family":"Hung","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hsiu-Lan","family":"Weng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8422-5797","authenticated-orcid":true,"given":"Yi-Chen","family":"Lai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3290-1909","authenticated-orcid":true,"given":"Jheng-Yan","family":"Wu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ping-Hsin","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kuei-Fen","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-7122-6901","authenticated-orcid":true,"given":"I-Wen","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2025,11,14]]},"reference":[{"issue":"1","key":"pone.0335677.ref001","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1186\/s12893-025-02930-9","article-title":"Incidence, outcomes and risk factors of postoperative urinary retention in patients undergoing primary total knee arthroplasty: a national inpatient sample database study","volume":"25","author":"J Li","year":"2025","journal-title":"BMC Surg"},{"issue":"2","key":"pone.0335677.ref002","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1016\/j.tjog.2024.12.007","article-title":"Incidences and risk factors of postoperative urinary retention after mid-urethral sling placement with and without pelvic reconstructive surgery","volume":"64","author":"M-J Sun","year":"2025","journal-title":"Taiwan J Obstet Gynecol"},{"issue":"4","key":"pone.0335677.ref003","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1097\/SPV.0000000000001631","article-title":"Effect of Older Age on Postoperative Urinary Retention After Prolapse Surgery","volume":"31","author":"KB McLarty","year":"2025","journal-title":"Urogynecology 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surgery","volume":"28","author":"I Tsouknidas","year":"2024","journal-title":"Hernia"},{"key":"pone.0335677.ref010","doi-asserted-by":"crossref","first-page":"111344","DOI":"10.1016\/j.jclinane.2023.111344","article-title":"Post-operative urinary retention is impacted by neuromuscular block reversal agent choice: A retrospective cohort study in US hospital setting","volume":"93","author":"LD Bash","year":"2024","journal-title":"J Clin Anesth"},{"key":"pone.0335677.ref011","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1111\/j.1365-2044.2008.05870.x","article-title":"Sugammadex in clinical practice","author":"RK Mirakhur","year":"2009","journal-title":"Anaesthesia"},{"issue":"7","key":"pone.0335677.ref012","doi-asserted-by":"crossref","first-page":"919","DOI":"10.2165\/00003495-200969070-00008","article-title":"Sugammadex: a review of its use in anaesthetic practice","volume":"69","author":"LPH 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randomized controlled trial","volume":"10","author":"TA Brouwer","year":"2021","journal-title":"Perioper Med (Lond)"},{"issue":"1","key":"pone.0335677.ref022","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1186\/s12871-023-02094-0","article-title":"Postoperative pulmonary complications after sugammadex reversal of neuromuscular blockade: a systematic review and meta-analysis with trial sequential analysis","volume":"23","author":"H-M Liu","year":"2023","journal-title":"BMC Anesthesiol"},{"issue":"1","key":"pone.0335677.ref023","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1186\/s12871-023-01979-4","article-title":"Analysis of the association of sugammadex with the length of hospital stay in patients undergoing abdominal surgery: a retrospective study","volume":"23","author":"J Tan","year":"2023","journal-title":"BMC Anesthesiol"},{"issue":"39","key":"pone.0335677.ref024","article-title":"Sugammadex for reversing neuromuscular blockages after lung surgery: A 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