title: Risk factors and preventive measures for acute urinary retention after rectal cancer surgery.
abstract: BACKGROUND
  Although several risk factors for acute urinary retention after rectal cancer surgery have been proposed, few studies have enrolled a homogeneous group of patients without preoperative urinary dysfunction. We aimed to identify risk factors and preventive measures for acute urinary retention after rectal cancer surgery.
  
  
  METHODS
  This study was a retrospective review of prospectively collected data from included patients who underwent rectal cancer surgery at a single center. Preoperative urinary function was evaluated using the International Prostate Symptom Score (IPSS). Clinical data were collected prospectively and analyzed to assess the risk factors for acute urinary retention, which was defined as the inability to self-void after removing the urinary catheter requiring catheterization or reinsertion of an indwelling catheter.
  
  
  RESULTS
  Of 352 patients with mild preoperative IPSS (0-7), 48 (13.6 %) experienced acute urinary retention. Multivariate logistic regression analysis showed that male sex (odds ratio [OR] 2.240, p = 0.039), laparoscopic operation (OR 2.421, p = 0.024), intraoperative intravenous fluid ≥ 2,000 mL (OR 3.794, p < 0.001), and urinary catheter removal on postoperative day 1 or 2 (OR 3.650, p = 0.017) were independent risk factors for acute urinary retention after rectal cancer surgery. Patients with two risk factors had a significantly higher risk of acute urinary retention than patients with none or one risk factor.
  
  
  CONCLUSIONS
  This study suggests the maintenance of a urinary catheter for a period longer than 2 days and intraoperative fluid restriction to prevent acute urinary retention after rectal cancer surgery.
authors.affiliation: Department of Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam-Si, Gyeonggi-do, 463-707, Korea.
authors.forename: Soo Young
authors.initials: SY
authors.lastname: Lee
authors.forename: Sung-Bum
authors.initials: SB
authors.lastname: Kang
authors.forename: Duck-Woo
authors.initials: DW
authors.lastname: Kim
authors.forename: Heung-Kwon
authors.initials: HK
authors.lastname: Oh
authors.forename: Myong Hoon
authors.initials: MH
authors.lastname: Ihn
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020878:Device Removal; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D007430:Intraoperative Care; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011183:Postoperative Complications; D012004:Rectal Neoplasms / Q000601:surgery*; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors; D014546:Urinary Catheterization; D016055:Urinary Retention / Q000209:etiology* / Q000517:prevention & control; D055815:Young Adult