Postoperative urinary retention after surgery for benign anorectal disease: potential risk factors and strategy for prevention

Toyonaga, T.; Matsushima, Makoto; Sogawa, Nobuhito; Jiang, Song Feng; Matsumura, Naomi; Shimojima, Yasuhiro; Tanaka, Yoshiaki; Suzuki, Kazunori; Masuda, Junnichi; Tanaka, Masao

doi:10.1007/s00384-005-0077-2

Cited by 180 publications

(155 citation statements)

References 16 publications

Supporting

Mentioning

124

Contrasting

Unclassified

Order By: Relevance

“…LUTS, the only subjective factor in the meta-analysis, was defined by only one study 40 and retrospectively applied in four of the six. Despite none of these studies being considered of low methodological quality on NOS assessment, the authors considered these papers at high risk of selection and reporting biases.…”

Section: Methodological Qualitymentioning

confidence: 99%

“…The only two studies that demonstrated a significant relationship both identified male gender as protective 40,45 , however once the studies had been pooled, male sex was not found to significantly influence the risk of developing POUR with a summary OR of 0.96 (figure 2, 95% CI 0.62-1.50, p=0.87). Including only prospective studies did not affect the lack of association between sex and POUR (data not shown).…”

Section: Gendermentioning

confidence: 99%

“…Ten studies [36][37][38][39][40]42,[45][46][47][48] (5624 patients) assessed the influence of gender on the risk of developing POUR. The only two studies that demonstrated a significant relationship both identified male gender as protective 40,45 , however once the studies had been pooled, male sex was not found to significantly influence the risk of developing POUR with a summary OR of 0.96 (figure 2, 95% CI 0.62-1.50, p=0.87).…”

Section: Gendermentioning

confidence: 99%

See 2 more Smart Citations

Patient-related risk factors for urinary retention following ambulatory general surgery: a systematic review and meta-analysis

Mason

Scott

Mayer

et al. 2016

The American Journal of Surgery

View full text Add to dashboard Cite

show abstract

Section: Methodological Qualitymentioning

confidence: 99%

Section: Gendermentioning

confidence: 99%

Section: Gendermentioning

confidence: 99%

See 1 more Smart Citation

Patient-related risk factors for urinary retention following ambulatory general surgery: a systematic review and meta-analysis

Mason

Scott

Mayer

et al. 2016

The American Journal of Surgery

View full text Add to dashboard Cite

show abstract

“…3,11,14,15,17,18,83 Urinary retention is dependent on the severity of disease and degree of surgery, the analgesia requirement and pre-existing bladder outlet compromise. [85][86][87] In addition, day case treatment may reduce the incidence. 88 Both cases of urinary retention in our trial had HAL combined with significant mucopexy (more than five mucopexy sutures).…”

Section: Surgical Complicationsmentioning

confidence: 99%

The HubBLe Trial: haemorrhoidal artery ligation (HAL) versus rubber band ligation (RBL) for symptomatic second- and third-degree haemorrhoids: a multicentre randomised controlled trial and health-economic evaluation

Brown

Tiernan

Biggs

et al. 2016

Health Technol Assess

View full text Add to dashboard Cite

BackgroundOptimal surgical intervention for low-grade haemorrhoids is unknown. Rubber band ligation (RBL) is probably the most common intervention. Haemorrhoidal artery ligation (HAL) is a novel alternative that may be more efficacious.ObjectiveThe comparison of HAL with RBL for the treatment of grade II/III haemorrhoids.DesignA multicentre, parallel-group randomised controlled trial.PerspectiveUK NHS and Personal Social Services.Setting17 NHS Trusts.ParticipantsPatients aged ≥ 18 years presenting with grade II/III (second- and third-degree) haemorrhoids, including those who have undergone previous RBL.InterventionsHAL with Doppler probe compared with RBL.OutcomesPrimary outcome – recurrence at 1 year post procedure; secondary outcomes – recurrence at 6 weeks; haemorrhoid severity score; European Quality of Life-5 Dimensions, 5-level version (EQ-5D-5L); Vaizey incontinence score; pain assessment; complications; and cost-effectiveness.ResultsA total of 370 participants entered the trial. At 1 year post procedure, 30% of the HAL group had evidence of recurrence compared with 49% after RBL [adjusted odds ratio (OR) = 2.23, 95% confidence interval (CI) 1.42 to 3.51;p = 0.0005]. The main reason for the difference was the number of extra procedures required to achieve improvement/cure. If a single HAL is compared with multiple RBLs then only 37.5% recurred in the RBL arm (adjusted OR 1.35, 95% CI 0.85 to 2.15;p = 0.20). Persistence of significant symptoms at 6 weeks was lower in both arms than at 1 year (9% HAL and 29% RBL), suggesting significant deterioration in both groups over the year. Symptom score, EQ-5D-5L and Vaizey score improved in both groups compared with baseline, but there was no difference between interventions. Pain was less severe and of shorter duration in the RBL group; most of the HAL group who had pain had mild to moderate pain, resolving by 3 weeks. Complications were low frequency and not significantly different between groups. It appeared that HAL was not cost-effective compared with RBL. In the base-case analysis, the difference in mean total costs was £1027 higher for HAL. Quality-adjusted life-years (QALYs) were higher for HAL; however, the difference was very small (0.01) resulting in an incremental cost-effectiveness ratio of £104,427 per additional QALY.ConclusionsAt 1 year, although HAL resulted in fewer recurrences, recurrence was similar to repeat RBL. Symptom scores, complications, EQ-5D-5L and continence score were no different, and patients had more pain in the early postoperative period after HAL. HAL is more expensive and unlikely to be cost-effective in terms of incremental cost per QALY.LimitationsBlinding of participants and site staff was not possible.Future workThe incidence of recurrence may continue to increase with time. Further follow-up would add to the evidence regarding long-term clinical effectiveness and cost-effectiveness. The polysymptomatic nature of haemorrhoidal disease requires a validated scoring system, and the data from this trial will allow further assessment of validity of such a system. These data add to the literature regarding treatment of grade II/III haemorrhoids. The results dovetail with results from the eTHoS study [Watson AJM, Hudson J, Wood J, Kilonzo M, Brown SR, McDonald A,et al.Comparison of stapled haemorrhoidopexy with traditional excisional surgery for haemorrhoidal disease (eTHoS): a pragmatic, multicentre, randomised controlled trial.Lancet2016, in press.] comparing stapled haemorrhoidectomy with excisional haemorrhoidectomy. Combined results will allow expansion of analysis, allowing surgeons to tailor their treatment options to individual patients.Trial registrationCurrent Controlled Trials ISRCTN41394716.FundingThis project was funded by the NIHR Health Technology Assessment programme and will be published in full inHealth Technology Assessment; Vol. 20, No. 88. See the NIHR Journals Library website for further project information.

show abstract

“…Post-operative urinary retention (POUR) is defined as the inability to void after surgery when the bladder is full (1,2) POUR is common and represents between 5% to 70% of all surgeries (1), especially after herniorrhaphy (3,4) and anorectal surgery (5)(6)(7). Typically, this phenomenon is painful and can result in increased cost of hospitalization, prolonged length of hospital stay, bladder overdistension, and urinary tract infection (UTI) which can occur primarily or secondarily to catheterization (1,8).…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of tamsulosin in prevention of post-operative urinary retention: a randomized double-blind placebo-controlled study

Mokhtari

et al. 2014

Int. braz j urol.

View full text Add to dashboard Cite

ARTICLE INFO ______________________________________________________________ ______________________Purpose: Urinary retention is one of the most common complications contributing to surgical procedures. Recent studies have shown the benefits of alpha-adrenergic blockers in preventing post-operative urinary retention (POUR). The aim of this prospective study was to compare the prophylactic effect of tamsulosin with placebo on postoperative urinary retention. Materials and Methods:In this randomized placebo controlled, clinical trial, 232 male patients aged 18 to 50 years old admitted to Razi University Hospital for varicocelectomy, inguinal herniorrhaphy, and scrotal surgery were randomly assigned to receive either three doses of 0.4mg tamsulosin (n = 118) or placebo (n = 114), 14 and 2 hours before, and 10 hours after surgery. Patients were closely monitored for the development of urinary retention 24 hours after surgical intervention. The primary endpoint was to investigate the effect of tamsulosin in prevention of post-operative urinary retention during the first 24 hours after surgical intervention. Collected data were analyzed using SPSS software version 18 and the P < 0.05 was considered statistically significant. Results: One hundred and eighteen patients were included in tamsulosin arm and 114 in placebo arm. POUR in patients who received tamsulosin was significantly lower than placebo, as 5.9% of the patients treated with tamsulosin and 21.1% placebo group, reported urinary retention following surgery (P = 0.001). No serious adverse effects were seen in both groups.Conclusions: This study suggests that short perioperative treatment with tamsulosin can reduce the incidence of urinary retention and the need for catheterization after varicocelectomy, inguinal herniorrhaphy, and scrotal surgery.

show abstract

Postoperative urinary retention after surgery for benign anorectal disease: potential risk factors and strategy for prevention

Cited by 180 publications

References 16 publications

Patient-related risk factors for urinary retention following ambulatory general surgery: a systematic review and meta-analysis

Patient-related risk factors for urinary retention following ambulatory general surgery: a systematic review and meta-analysis

The HubBLe Trial: haemorrhoidal artery ligation (HAL) versus rubber band ligation (RBL) for symptomatic second- and third-degree haemorrhoids: a multicentre randomised controlled trial and health-economic evaluation

Effectiveness of tamsulosin in prevention of post-operative urinary retention: a randomized double-blind placebo-controlled study

Contact Info

Product

Resources

About