Incidence of Postoperative Nausea and Vomiting After Urological Procedures

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.