Acute Delirium Post-inguinal Hernia Mesh Repair in a 40-Year-Old Male: An Unusual Case of Cystocerebral Syndrome

• Published in: Curēus (Palo Alto, CA) Vol. 15; no. 7
• Main Authors: Arora, Gagandeep Singh, Kaur, Parneet
• Format: Journal Article
• Language: English
• Published: Palo Alto Cureus Inc 21-07-2023; Cureus
• Subjects: Anesthesia; Bladder; Blood pressure; Case reports; Catheters; Cognitive ability; Complex patients; Consciousness; Delirium; Drug withdrawal; Electrolytes; Hernias; Internal Medicine; Intubation; Medical imaging; Neurology; Older people; Pain; Surgery; Surgical outcomes; Ultrasonic imaging; Urinary retention; Urinary tract diseases; Urinary tract infections; Urine; Urogenital system; Urology
• ISSN: 2168-8184; 2168-8184
• DOI: 10.7759/cureus.42260

Acute urinary retention is a known complication of inguinal hernia repair. However, the development of severe agitation and delirium as a result of acute urinary retention following inguinal hernia repair is less commonly reported. Here, we present the case of a 40-year-old male with no relevant medical history who underwent open mesh hernia repair for an uncomplicated left-sided indirect inguinal hernia. Postoperatively, the patient became hypertensive, delirious, and violent. He was found to have urinary retention on a bladder scan. Urgent intervention with catheterization and bladder decompression resulted in the prompt resolution of the patient’s symptoms. The patient regained his senses and did not remember the events that led to it. This case highlights the importance of recognizing and managing acute urinary retention to prevent the development of severe agitation and delirium following spinal anesthesia. Further research and awareness are necessary to better understand the underlying neurovisceral mechanisms and optimize preventive strategies.