INCIDENCE OF POSTOPERATIVE NAUSEA AND VOMITING AFTER UROLOGICAL PROCEDURES
DOI:
https://doi.org/10.71000/c5czvy08Keywords:
, Recovery, Anesthesia, Antiemetics, Nausea, Postoperative Complications, Urologic Surgical Procedures, General, VomitingAbstract
Background: Postoperative nausea and vomiting (PONV) are among the most frequent and distressing complications following surgery, particularly in urological procedures. Despite improvements in anesthesia and perioperative management, PONV continues to impair patient comfort, delay recovery, and prolong hospital discharge. Understanding its incidence and associated risk factors in urological surgery is vital for improving patient outcomes and optimizing preventive strategies.
Objective: To determine the incidence of postoperative nausea and vomiting (PONV) in patients undergoing urological surgeries under anesthesia and to identify associated demographic and procedural risk factors.
Methods: This observational cross-sectional study was conducted at Aman General Hospital, Peshawar, Pakistan, over a period of four to six months. A total of 160 adult patients aged 18 years and above, scheduled for elective urological surgeries under either spinal or general anesthesia, were recruited through non-probability convenience sampling. Data were collected using a structured proforma that included demographic variables, anesthesia type, surgical duration, and postoperative symptoms. Statistical analysis was performed using SPSS version 25. Descriptive statistics summarized frequencies and percentages, while Chi-square tests evaluated associations between gender, anesthesia type, and PONV.
Results: Of 160 participants, 96 (60.0%) were male and 64 (40.0%) were female, with the largest age group being 51–60 years (40.0%). Nausea occurred in 53 patients (33.1%) and vomiting in 28 (17.5%). Female patients exhibited significantly higher rates of nausea (46.9%) and vomiting (40.6%) than males (p = 0.003 and p < 0.001, respectively). Spinal anesthesia was used in 96 cases (60.0%) and general anesthesia in 64 (40.0%). Only 60 patients (37.5%) received antiemetics, which were effective when administered. Vomiting delayed discharge or recovery in 43 patients (26.9%).
Conclusion: PONV remains a common and clinically relevant issue in urological surgery, particularly among female patients and those with prior PONV or motion sickness. The persistence of symptoms despite spinal anesthesia indicates a multifactorial etiology. The low rate of antiemetic use highlights the need for better adherence to preventive protocols. Proactive, multimodal management strategies are recommended to minimize PONV and improve postoperative recovery.
References
Allene, M. D., & Demsie, D. G. (2020a). Incidence and factors associated with postoperative nausea and vomiting at Debre Berhan referral hospital, NorthShewa, Ethiopia: Across-sectional study. International Journal of Surgery Open, 25, 29–34.
Allene, M. D., & Demsie, D. G. (2020b). Incidence and factors associated with postoperative nausea and vomiting at Debre Berhan referral hospital, NorthShewa, Ethiopia: Across-sectional study. International Journal of Surgery Open, 25, 29–34.
Demilew, B. C., Zurbachew, N., Getachew, N., Mekete, G., & Teshome, D. (2025). Prevalence and associated factors of intraoperative Nausea and Vomiting of mothers who gave birth with cesarean section under regional anesthesia: a systematic review and meta-analysis; 2023. BMC Pregnancy and Childbirth, 25(1).
Douville, N. J., Bastarache, L., He, J., Wu, K.-H. H., Vanderwerff, B., Bertucci-Richter, E., Hornsby, W. E., Lewis, A., Jewell, E. S., Kheterpal, S., Shah, N., Mathis, M., Engoren, M. C., Douville, C. B., Surakka, I., Willer, C., & Kertai, M. D. (2024). Polygenic Score for the Prediction of Postoperative Nausea and Vomiting: A Retrospective Derivation and Validation Cohort Study. Anesthesiology, 0(1), 52–71.
Faheem, K., Faheem, K., Zaheer, F., Salman, S., Shahab, H., Jawaid, B., Shakeel, B., & Words, K. (2023). Evaluation of Post-Operative and Post-Discharge Nausea Vomiting and Associated Risk Factors Among Patients Undergoing Ambulatory Laparoscopic Cholecystectomy in Tertiary Care Hospital. 209–215.
Gan, T. J., Belani, K. G., Bergese, S., Chung, F., Diemunsch, P., Habib, A. S., Jin, Z., Kovac, A. L., Meyer, T. A., Urman, R. D., Apfel, C. C., Ayad, S., Beagley, L., Candiotti, K., Englesakis, M., Hons, B. A., Hedrick, T. L., Kranke, P., Lee, S., … Philip, B. K. (2020). Fourth Consensus Guidelines for the Management of Postoperative Nausea and Vomiting.
Huang, Q., Wang, F., Liang, C., Huang, Y., Zhao, Y., Liu, C., Lin, C., Zhang, L., Zhou, S., Wang, Q., Li, S., Gong, R., Wu, Q., Gu, Y., Zhang, J., Luo, T., Wang, W., Zhang, S., Bizo Mailoga, N., … Zhao, Y. (2023). Fosaprepitant for postoperative nausea and vomiting in patients undergoing laparoscopic gastrointestinal surgery: a randomised trial. British Journal of Anaesthesia, 131(4), 673–681.
Huh, H. (2023). Postoperative nausea and vomiting in spinal anesthesia. Korean Journal of Anesthesiology, 76(2), 87–88.
Ilyas, M., Mehtab, M., Farooq, M., Zaman, S., Riaz, N., Fatima, S., & Mahmood, S. (2025). insights-journal of life and social sciences post-operative nausea comparison of general and vomiting , anesthesia and. 88–94.
Klenke, S., & Frey, U. H. (2020). Genetic variability in postoperative nausea and vomiting: A systematic review. European Journal of Anaesthesiology, 37(11), 959–968.
Kovac, A. L. (2020). Postoperative Nausea and Vomiting in Pediatric Patients. Pediatric Drugs, 0123456789.
Kranke, P., Meybohm, P., Diemunsch, P., & Eberhart, L. H. J. (2020). Risk-adapted strategy or universal multimodal approach for PONV prophylaxis? In Best Practice and Research: Clinical Anaesthesiology (Vol. 34, Issue 4). Elsevier Ltd.
Ogata, F., Nakamura, T., Hoshijima, H., Doi, K., Nagasaka, H., & Mieda, T. (2024). Postoperative Nausea and Vomiting after Minor Oral Surgery: A Retrospective Cohort Study. Anesthesia Progress, 71(4), 163–170.
Rahimi, M., Majedi, H., Shamsi, A., Eftekhar, N., & Kadhim, R. A. (2023). Journal of Population Therapeutics & Clinical Pharmacology. 30(March), 112–122.
Sinha, V., Vivekanand, D., & Singh, S. (2022). Prevalence and risk factors of post-operative nausea and vomiting in a tertiary-care hospital: A cross-sectional observational study. Medical Journal Armed Forces India, 78, S158–S162.
Tan, H. Sen, Dewinter, G., & Habib, A. S. (2020). The next generation of antiemetics for the management of postoperative nausea and vomiting. Best Practice and Research: Clinical Anaesthesiology, 34(4), 759–769.
Teshome, D., Hunie, M., Kibret, S., Mestofa, M., & Fenta, E. (2024). Prevalence and Factors Associated with Postoperative Nausea and Vomiting in an Ethiopian Comprehensive Specialized Hospital. Advances in Preventive Medicine, 2024, 1–6.
Weibel, S., Rücker, G., Lhj, E., Nl, P., Hm, H., Ol, J., Mayer, D., Riemer, M., Weibel, S., Rücker, G., Lhj, E., Nl, P., Hm, H., Ol, J., Mayer, D., Riemer, M., Ms, S., Raj, D., Backhaus, I., … Kranke, P. (2020). a er general anaesthesia : a network meta-analysis ( Review ).
Weibel, S., Schaefer, M. S., Raj, D., R, G., Pace, N. L., Schlesinger, T., & Meybohm, P. (2020). Drugs for preventing postoperative nausea and vomiting in adults after general anaesthesia : an abridged Cochrane.
Zhao Y, Hao J, Yan Q, Lin K, Zheng Y, Wu B. Study on the sedative effect of dexmedetomidine in radical prostatectomy: A retrospective study. Medicine (Baltimore). 2025;104(32):e43427.
Yoon HK, Joo S, Yoon S, Seo JH, Kim WH, Lee HJ. Randomized controlled trial of the effect of general anesthetics on postoperative recovery after minimally invasive nephrectomy. Korean J Anesthesiol. 2024;77(1):95-105.
Alvi AS, Nasir JA, Nizam MA, Hamdani MM, Bhangar NA, Sibtain SA, et al. Quadratus lumborum block and transversus abdominis plane block in laparoscopic nephrectomy: a meta-analysis. Pain Manag. 2023;13(9):555-67.
Kishikawa H, Suzuki N, Suzuki Y, Hamasaki T, Kondo Y, Sakamoto A. Effect of Robot-assisted Surgery on Anesthetic and Perioperative Management for Minimally Invasive Radical Prostatectomy under Combined General and Epidural Anesthesia. J Nippon Med Sch. 2021;88(2):121-7.
Micali M, Cucciolini G, Bertoni G, Gandini M, Lattuada M, Santori G, et al. Analgesic Strategies for Urologic Videolaparoscopic or Robotic Surgery in the Context of an Enhanced Recovery after Surgery Protocol: A Prospective Study Comparing Erector Spinae Plane Block versus Transversus Abdominis Plane Block. J Clin Med. 2024;13(2).
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Shahzaib, Muhammad Bilal, Amir, Wajahat Rehman (Author)
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
