[Risk factors of postoperative urinary retention after rectal cancer surgery].
OBJECTIVE
To investigate the risk factors of postoperative urinary retention after rectal cancer surgery.


METHODS
Clinical data of 133 patients with rectal cancer undergoing radical surgery from January 2013 to September 2014 in the General Hospital of the PLA Rocket Force were retrospectively analyzed. Time to the first removal of urinary catheter, incidence of postoperative urinary retention, and time to re-insert indwelling catheter were recorded. Risk factors of urinary retention were analyzed.


RESULTS
Of 133 patients, 70 were males and 63 were females, with a median age of 62 (20-79) years old. Distance from tumor lower margin to anal verge were ≤5 cm in 58 patients, >5 cm to 10 cm in 41 patients, and >10 cm to 15 cm in 34 patients. The postoperative TNM stage was recorded in 35 patients with stage I(, 34 with stage II(, 59 with stage III( and 5 with stage IIII(. Surgical procedures included anterior resection (AR) for 92 patients, abdominoperineal resection (APR) for 25 patients and intersphincteric resection (ISR) for 16 patients. Laparoscopic approach was performed in 89 patients compared with open operation in 44 patients. Time to the first removal of urinary catheter was 2-7 days after operation (median, 5 days) and 36 (27.1%) patients developed urinary retention. All the 36 patients achieved spontaneous voiding by re-inserting urinary catheter for 2-28 days (median, 6 days). Univariate analysis showed that elderly (>65 years) and laparoscopic approach had significantly higher incidence of urinary retention [37.5%(21/56) vs. 19.5%(15/77), χ2=5.333, P=0.021; 34.8%(31/89) vs. 11.4%(5/44), χ2=8.214, P=0.004; respectively]. Multivariate logistic analysis demonstrated that old age(OR=3.949, 95%CI:1.622 to 9.612, P=0.002), laparoscopic approach (OR=5.665, 95%CI:1.908 to 16.822, P=0.002), and abdominoperineal resection (OR=3.443, 95%CI:1.199 to 9.887, P=0.022) were independent risk factors of urinary retention after rectal cancer surgery.


CONCLUSIONS
Patients undergoing rectal cancer surgery have a high risk of postoperative urinary retention. More attention should be paid to the old patients, especially those undergoing laparoscopic procedure or abdominoperineal resection, to prevent postoperative urinary retention and urinary dysfunction.
Yong
Y
Zhao
Xiaoling
X
Hou
Yujuan
Y
Zhao
Yingying
Y
Feng
Bin
B
Zhang
Department of Colorectal Surgery, The General Hospital of The PLA Rocket Force, Beijing 100088, China. studentinbj@163.com.
Ke
K
Zhao
D000328:Adult; D000367:Age Factors; D000368:Aged; D001003:Anal Canal / Q000601:surgery; D012809:Colon, Sigmoid / Q000601:surgery; D013505:Digestive System Surgical Procedures / Q000009:adverse effects* / Q000379:methods* / Q000706:statistics & numerical data; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects* / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D012004:Rectal Neoplasms / Q000145:classification / Q000601:surgery*; D012007:Rectum / Q000601:surgery; D012189:Retrospective Studies; D012307:Risk Factors; D014546:Urinary Catheterization / Q000706:statistics & numerical data; D016055:Urinary Retention / Q000453:epidemiology*; D014554:Urination / Q000502:physiology