TY - JOUR
T1 - Early removal of urinary catheters after rectal surgery is associated with increased urinary retention
AU - Kwaan, Mary R.
AU - Lee, Janet T.
AU - Rothenberger, David A.
AU - Melton, Genevieve B.
AU - Madoff, Robert D.
N1 - Publisher Copyright:
© The ASCRS 2015.
PY - 2015/4
Y1 - 2015/4
N2 - BACKGROUND: Urinary retention after rectal resection is common and managed prophylactically by prolonging urinary catheterization. However, because indwelling urinary catheterization is a well-established risk factor for urinary tract infection, the ideal timing for urinary catheter removal following a rectal resection is unknown. OBJECTIVE: We hypothesized that early urinary catheter removal (on or before postoperative day 2) would be associated with urinary retention. DESIGN: This study is a retrospective review of medical records. SETTING: This study was conducted at a colorectal surgery service at a tertiary care academic teaching hospital. PATIENTS: Adults undergoing rectal resection operations by colorectal surgeons in 2005 to 2010 were selected. MAIN OUTCOME MEASURE: The primary outcome measured was urinary retention. RESULTS: Of 205 patients included, 41 (20%) developed urinary retention. Male sex (OR, 3.9; 95% CI, 1.7-9), increased intraoperative intravenous fluid (OR for each liter, 1.2; 95% CI, 1.04-1.48), and urinary catheter removal on postoperative day 2 or earlier (OR, 3.8; 95% CI, 1.4-10.5) were associated with urinary retention on multivariable analysis. Early catheter removal was not associated with decreased urinary tract infection rates (p = 0.29) but was associated with shorter length of stay (6.5 vs 8.9 days; p = 0.005). LIMITATIONS: The retrospective nature of this study did not allow for a precise definition of urinary retention. Preoperative urinary function was not available, and the patient sample was heterogeneous, including several indications for rectal resection. Urinary catheters were not removed per protocol and therefore subject to bias. The study is likely underpowered to detect differences in urinary tract infection between urinary catheter removal groups. CONCLUSION: In patients undergoing rectal resection, we found that urinary catheter removal on or before postoperative day 2 was associated with urinary retention (see Video, Supplemental Digital Content 1, http://links. lww.com/DCR/A172).
AB - BACKGROUND: Urinary retention after rectal resection is common and managed prophylactically by prolonging urinary catheterization. However, because indwelling urinary catheterization is a well-established risk factor for urinary tract infection, the ideal timing for urinary catheter removal following a rectal resection is unknown. OBJECTIVE: We hypothesized that early urinary catheter removal (on or before postoperative day 2) would be associated with urinary retention. DESIGN: This study is a retrospective review of medical records. SETTING: This study was conducted at a colorectal surgery service at a tertiary care academic teaching hospital. PATIENTS: Adults undergoing rectal resection operations by colorectal surgeons in 2005 to 2010 were selected. MAIN OUTCOME MEASURE: The primary outcome measured was urinary retention. RESULTS: Of 205 patients included, 41 (20%) developed urinary retention. Male sex (OR, 3.9; 95% CI, 1.7-9), increased intraoperative intravenous fluid (OR for each liter, 1.2; 95% CI, 1.04-1.48), and urinary catheter removal on postoperative day 2 or earlier (OR, 3.8; 95% CI, 1.4-10.5) were associated with urinary retention on multivariable analysis. Early catheter removal was not associated with decreased urinary tract infection rates (p = 0.29) but was associated with shorter length of stay (6.5 vs 8.9 days; p = 0.005). LIMITATIONS: The retrospective nature of this study did not allow for a precise definition of urinary retention. Preoperative urinary function was not available, and the patient sample was heterogeneous, including several indications for rectal resection. Urinary catheters were not removed per protocol and therefore subject to bias. The study is likely underpowered to detect differences in urinary tract infection between urinary catheter removal groups. CONCLUSION: In patients undergoing rectal resection, we found that urinary catheter removal on or before postoperative day 2 was associated with urinary retention (see Video, Supplemental Digital Content 1, http://links. lww.com/DCR/A172).
KW - Catheter-associated urinary tract infection
KW - Complications
KW - Outcomes
KW - Proctectomy
KW - Rectal cancer
KW - Urinary retention
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U2 - 10.1097/DCR.0000000000000317
DO - 10.1097/DCR.0000000000000317
M3 - Article
C2 - 25751796
AN - SCOPUS:84929515600
SN - 0012-3706
VL - 58
SP - 401
EP - 405
JO - Diseases of the colon and rectum
JF - Diseases of the colon and rectum
IS - 4
ER -
