36 The learning curve for the laparoscopic techniques may be significant enough to prevent some surgeons from offering the technique to their patients.
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43 , 45 In a meta-analysis performed by Tam et al., the incidence of POUR was found to be higher in patients with tack fixation presumably because of increased pain (3.1 vs > 1.0%), but this difference did not reach statistical significance. 46 Other meta-analyses have not demonstrated a difference in urinary retention when comparing tack fixation with glue. 47 Meta-analyses of RCTs comparing various hernia techniques have not shown a difference in urinary retention rates among the various laparoscopic and open techniques. 48 , 49 Many surgeons routinely place urinary catheters for inguinal herniorrhaphy especially when done laparoscopically. 43 , 45 This seems to be more a surgical tradition, not an evidence-based practice.