Postoperative urinary retention after primary colorectal cancer resection via laparotomy: a prospective study of 2,355 consecutive patients.
OBJECTIVE
The risk factors for postoperative urinary retention after colorectal carcinoma surgery can be clearly defined. This study was designed to determine risk factors for postoperative urinary retention after colorectal cancer surgery.


METHODS
A total of 2,355 consecutive patients with colorectal cancer who underwent open resection for colorectal cancer during a four-year period were included. The association between dependent and independent variables (including 19 clinicopathologic and surgical factors) was analyzed by using the chi-squared test or Fisher's exact test, as appropriate. The significant variables in the univariate analyses were included in multivariate analysis.


RESULTS
The overall prevalence of postoperative urinary retention was 5.5 percent (colon cancer, 1.7 percent; rectal cancer, 9.1 percent, P < 0.0001). Multivariate analysis showed an independent association between postoperative urinary retention and age, lung disease, tumor location, operation duration, and additional pelvic procedure. Of the 121 patients with postoperative urinary retention, urine catheterization was required in 42 patients one month postoperatively. Discriminate analysis showed that gender, American Society of Anesthesiologists' score, tumor location, presence of drainage, and pelvic infection were best able to discriminate between prolonged (>1 month) and transient urinary dysfunction.


CONCLUSIONS
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.
Changchien
Chung Rong
CR
Department of Surgery, Colorectal Section, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taipei, Taiwan.
Yeh
Chien Yuh
CY
Huang
Shih Tsung
ST
Hsieh
Ming-Li
ML
Chen
Jinn-Shiun
JS
Tang
Reiping
R
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007813:Laparotomy; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D016055:Urinary Retention / Q000453:epidemiology*