Predictors of Postoperative Urinary Retention After Colorectal Surgery

Kin, Cindy; Rhoads, Kim F.; Jalali, Moe; Shelton, Andrew; Welton, Mark L.

doi:10.1097/dcr.0b013e318280aad5

Cited by 57 publications

(45 citation statements)

References 64 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…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.…”

Section: Discussionmentioning

confidence: 91%

“…As there is a push to remove urinary catheters earlier to avoid UTI, we may inadvertently increase rates of urinary retention [4,5,7]. Though most postoperative urinary retention is transient [7], the higher baseline rates of UR in patients undergoing pelvic surgery create a management dilemma.…”

Section: Discussionmentioning

confidence: 95%

“…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.…”

Section: Introductionmentioning

confidence: 98%

“…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].…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

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

Poylin

Curran

Cataldo

et al. 2015

Int J Colorectal Dis

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

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

Poylin

Curran

Cataldo

et al. 2015

Int J Colorectal Dis

View full text Add to dashboard Cite

show abstract

“…Longer duration of urinary drainage should be considered after low anterior and abdominoperineal resection, as these procedures may be associated with higher retention rates [ 74 ]. Minimizing perioperative fl uid resuscitation may decrease the incidence of urinary retention [ 75 ].…”

Section: Urinary Drainage and Ureteral Stentingmentioning

confidence: 99%

Perioperative Assessment

Kvasnovsky

Bafford²

2014

Minimally Invasive Approaches to Colon and Rectal Disease

View full text Add to dashboard Cite

Key Points• Pneumoperitoneum leads to increased cardiac preload and afterload, hypotension, increased airway pressures, increased end-tidal CO 2 , and decreased urine output.• Laparoscopic colorectal surgery is associated with decreases in postoperative pain, ileus, length of hospital stay, and wound complications, and improved cosmesis when compared to open surgery.• Oncologic outcomes and IBD recurrence rates are similar after laparoscopic and open colectomy.• Routine laboratory studies are recommended prior to laparoscopic colorectal surgery. More intensive cardiopulmonary testing should be reserved for symptomatic patients and those with signifi cant risk factors.• Laparoscopic surgery can be safely performed in elderly and obese patients as well as in certain cases of emergency and reoperative surgery.• Bowel preparation should generally be used in order to improve maneuverability of the bowel and to allow for intraoperative endoscopy.• Colorectal tumors should be localized with 4-quadrant tattooing and Crohn's lesions with imaging and endoscopy prior to surgery.• Patients should be securely positioned with arms tucked and legs apart (for left colon and rectal procedures).• Judicious fl uid administration, early feeding and mobilization, and minimization of narcotics should be part of postoperative care. Physiologic Effects of LaparoscopyPneumoperitoneum is the sine qua non of laparoscopic surgery. Insuffl ation of the abdomen has both mechanical and physiologic effects. These changes become especially relevant in colorectal surgery, where positioning varies steeply over the course of operations. Colorectal operations may also be prolonged, which can further amplify effects. Although less than ideal, carbon dioxide (CO 2 ) is currently the primary gas being used in laparoscopic surgery. The ideal gas would be noncombustible, colorless, and have limited physiologic effects. Because electrocautery is commonly used in laparoscopic surgery, combustible gases are absolutely contraindicated [ 1 ]. This precludes the use of oxygen, room air (which is 21 % oxygen), and nitrous oxide. Meanwhile, helium and argon as inert gases would fulfi ll the requirement of nonfl ammability; however, they have lower thresholds for toxicity. CO 2 remains the gas of choice. Transperitoneal absorption of CO 2 results in increased dissolved CO 2 in the blood, which can create a mild acidosis and hypercapnia.Pneumoperitoneum causes further physiologic effects that may infl uence decision-making in colorectal surgery. The majority of these changes will be well tolerated in ASA I and II patients (Table 1.1 ). For those with higher ASA grades, the effect is highly variable and often more problematic. Cardiovascular EffectsThere are many cardiovascular and hemodynamic changes during laparoscopic surgery as well as concomitant changes with positioning (Table 1.2 ). These do not usually affect

show abstract

Risk Factors and Preventive Measures for Acute Urinary Retention after Rectal Cancer Surgery

et al. 2014

View full text Add to dashboard Cite

show abstract

Predictors of Postoperative Urinary Retention After Colorectal Surgery

Abstract: The practice of earlier urinary catheter removal must be balanced with operative time and fluid volume to avoid high urinary retention rates. Also important is increased vigilance for the early detection of retention.

Cited by 57 publications

References 64 publications

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

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

Perioperative Assessment

Risk Factors and Preventive Measures for Acute Urinary Retention after Rectal Cancer Surgery

Contact Info

Product

Resources

About