Postoperative Urinary Retention After Primary Colorectal Cancer Resection via Laparotomy: A Prospective Study of 2,355 Consecutive Patients

Abstract

Older patients, lung disease, rectal cancer, longer operation duration, and additional pelvic procedure were at greater risk. There is a time-dependent change in postoperative urinary dysfunction. Male gender, American Society of Anesthesiologists' score of 2 or 3, rectal tumor, surgical drain, and pelvic infection can identify patients at risk for prolonged urinary dysfunction.

Perioperative use of tamsulosin significantly decreases rates of urinary retention in men undergoing pelvic surgery

“…In this study of men undergoing pelvic colorectal surgery, the overall rate of urinary retention was 22 %, with a fourfold decrease in retention (6.7 vs. 25 %) if tamsulosin was given for 3 days prior to pelvic surgery. Despite the study group population being older and having more minimally invasive surgery (both known risk factors for UR [5,7]), it had lower rates of urinary retention. This suggests a potential benefit of the routine use of tamsulosin in the perioperative setting for pelvic surgery.…”

“…Accordingly, Medicare and Medicaid have discontinued reimbursement for the care of UTI in the postoperative setting, labeling them a potentially preventable condition. While this has put additional pressure for quicker removal of catheters, early (within 48 h after surgery) removal of urinary catheters has been associated with increased rates of urinary retention (UR) [4][5][6][7][8][9]. Reported rates of UR after pelvic surgery have been between 5 and 22 %, higher than those reported after upper abdominal surgery.…”

“…Multiple factors have been associated with an increased risk of UR including age, duration of surgery, type of surgery, and level of anastomosis in the pelvis [2,5,8,9]. In particular, reported rates of UR are higher in men than in women [6][7][8][9]. The increased incidence of UR in pelvic surgery is likely multifactorial resulting from prolonged operative times in pelvic surgery (and thus higher fluid intake), prostatism and potential damage to pelvic nerves [8][9][10].…”

Lighted ureteral stents in laparoscopic colorectal surgery; a five-year experience

“…However, the hematuria resolved in all cases. Ureteral edema and subsequent urinary retention has been reported as a complication of ureteral stent placement (9). Nineteen patients (4%) required Foley reinsertion during the postoperative period prior to discharge.…”

Chirurgie des kolorektalen Karzinoms

“…In Los Angeles, CA, USA, wurde eine interessante Fragestellung bearbeitet: Welche Auswirkungen hat die akzidentelle Splenektomie bei kolorektalen Resektionen [38] In einer sorgfältigen Arbeit wurden in Taipei, Taiwan, bei 2 355 offenen kolorektalen Karzinomoperationen aus einem 4-Jahres-Zeitraum viele Parameter mit der postoperativen Blasenentleerungsstörung korreliert [10]. Harnverhaltungen wurden bei 5,5% der Patienten beobachtet (1,7% nach Kolonresektion und 9,1% nach Rektumresektion).…”