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International Journal of Colorectal Disease

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01-03-2016 | Original Article

Management of postoperative bladder emptying after proctectomy in men for rectal cancer. A retrospective study of 190 consecutive patients

Authors: Cécile Bouchet-Doumenq, Jérémie H. Lefevre, Malika Bennis, Najim Chafai, Emmanuel Tiret, Yann Parc

Published in: International Journal of Colorectal Disease | Issue 3/2016

Abstract

Purpose

Evaluation of urinary drainage after rectal resection and identification of criteria associated with postoperative urinary dysfunction (UD). UD remains a clinical problem for up to two thirds of patients after rectal resection. Currently, there are no guidelines concerning duration or type of drainage.

Methods

One hundred ninety consecutive rectal resections (abdomino-perineal resection (APR = 47), mechanical coloanal anastomosis (MechCAA = 48), manual coloanal anastomosis (ManCAA = 47), colorectal anastomosis (CRA = 48)) in male patients were included. In patients with a transurethral catheterization (TUC), the drainage was removed at day 5. Patients with a suprapubic catheterization (SPC) underwent drainage removal according to the results of a clamping test at day 5. UD was defined as drainage removal after day 6 and/or acute urinary retention (AUR).

Results

Drainage types were SPC (n = 136, 72 %) and TUC (n = 54, 28 %). SPC was used more frequently after total mesorectal excision (TME) (APR, ManCAA, MechCAA) (83–92 %). Complications rates of SPC and TUC were 20 and 9 %. The clamping test was positive for 61 patients (48 %), and SPC was removed before/on POD6 without any episode of AUR. After TUC removal, two patients (4 %) had AUR. Seventy-two (38 %) patients had UD: 11 (6 %) were discharged with an indwelling catheter, and in 61 (32 %), the catheter was removed after day6. Three independent factors were associated with UD: diabetes (OR = 2.9 (1.2–7.7)), urological history (OR = 2.9 (1.2–7.6)), and TME (OR = 5.2 (2.3–13.5)).

Conclusion

The UD rate after surgery for rectal cancer was 38 %. The clamping test is accurate to prevent AUR after SPC removal. The three risk factors may serve to select good candidates for early catheter removal.

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Title: Management of postoperative bladder emptying after proctectomy in men for rectal cancer. A retrospective study of 190 consecutive patients
Authors: Cécile Bouchet-Doumenq
Jérémie H. Lefevre
Malika Bennis
Najim Chafai
Emmanuel Tiret
Yann Parc
Publication date: 01-03-2016
Publisher: Springer Berlin Heidelberg
Published in: International Journal of Colorectal Disease / Issue 3/2016
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-015-2471-8

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Springer Medicine

Management of postoperative bladder emptying after proctectomy in men for rectal cancer. A retrospective study of 190 consecutive patients

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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