Skip to main content

Advertisement

SpringerLink
Log in

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

  • Original Article
  • Published:
International Journal of Colorectal Disease Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Alfonsi P, Slim K, Chauvin M et al (2014) French guidelines for enhanced recovery after elective colorectal surgery. J Visc Surg 151:65–79

    Article  CAS  PubMed  Google Scholar 

  2. Beaussier M, El’ayoubi H, Schiffer E et al (2007) Continuous preperitoneal infusion of ropivacaine provides effective analgesia and accelerates recovery after colorectal surgery: a randomized, double-blind, placebo-controlled study. Anesthesiology 107:461–468

    Article  CAS  PubMed  Google Scholar 

  3. Bennis M, Parc Y, Lefevre JH et al (2012) Morbidity risk factors after low anterior resection with total mesorectal excision and coloanal anastomosis: a retrospective series of 483 patients. Ann Surg 255:504–510

    Article  PubMed  Google Scholar 

  4. Benoist S, Panis Y, Denet C et al (1999) Optimal duration of urinary drainage after rectal resection: a randomized controlled trial. Surgery 125:135–141

    Article  CAS  PubMed  Google Scholar 

  5. Burgos FJ, Romero J, Fernandez E et al (1988) Risk factors for developing voiding dysfunction after abdominoperineal resection for adenocarcinoma of the rectum. Dis Colon Rectum 31:682–685

    Article  CAS  PubMed  Google Scholar 

  6. Changchien CR, Yeh CY, Huang ST et al (2007) Postoperative urinary retention after primary colorectal cancer resection via laparotomy: a prospective study of 2,355 consecutive patients. Dis Colon Rectum 50:1688–1696

    Article  PubMed  Google Scholar 

  7. Chaudhri S, Maruthachalam K, Kaiser A et al (2006) Successful voiding after trial without catheter is not synonymous with recovery of bladder function after colorectal surgery. Dis Colon Rectum 49:1066–1070

    Article  PubMed  Google Scholar 

  8. Doeksen A, Gooszen JA, Van Duijvendijk P et al (2011) Sexual and urinary functioning after rectal surgery: a prospective comparative study with a median follow-up of 8.5 years. Int J Color Dis 26:1549–1557

    Article  Google Scholar 

  9. Gerstenberg TC, Nielsen ML, Clausen S et al (1980) Bladder function after abdominoperineal resection of the rectum for anorectal cancer. Urodynamic investigation before and after operative in a consecutive series. Ann Surg 191:81–86

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Heald RJ (1995) Total mesorectal excision is optimal surgery for rectal cancer: a Scandinavian consensus. Br J Surg 82:1297–1299

    Article  CAS  PubMed  Google Scholar 

  11. Jahn P, Beutner K, Langer G (2012) Types of indwelling urinary catheters for long-term bladder drainage in adults. Cochrane Database Syst Rev 10:CD004997

    PubMed  Google Scholar 

  12. Katsumi HK, Kalisvaart JF, Ronningen LD et al (2010) Urethral versus suprapubic catheter: choosing the best bladder management for male spinal cord injury patients with indwelling catheters. Spinal Cord 48:325–329

    Article  CAS  PubMed  Google Scholar 

  13. Lee SY, Kang SB, Kim DW et al (2015) Risk factors and preventive measures for acute urinary retention after rectal cancer surgery. World J Surg 39:275–282

    Article  PubMed  Google Scholar 

  14. Lim RS, Yang TX, Chua TC (2014) Postoperative bladder and sexual function in patients undergoing surgery for rectal cancer: a systematic review and meta-analysis of laparoscopic versus open resection of rectal cancer. Tech Coloproctol 18:993–1002

    Article  CAS  PubMed  Google Scholar 

  15. Maas CP, Moriya Y, Steup WH et al (1998) Radical and nerve-preserving surgery for rectal cancer in The Netherlands: a prospective study on morbidity and functional outcome. Br J Surg 85:92–97

    Article  CAS  PubMed  Google Scholar 

  16. O’kelly TJ, Mathew A, Ross S et al (1995) Optimum method for urinary drainage in major abdominal surgery: a prospective randomized trial of suprapubic versus urethral catheterization. Br J Surg 82:1367–1368

    Article  PubMed  Google Scholar 

  17. Pocard M, Zinzindohoue F, Haab F et al (2002) A prospective study of sexual and urinary function before and after total mesorectal excision with autonomic nerve preservation for rectal cancer. Surgery 131:368–372

    Article  PubMed  Google Scholar 

  18. Ratnaval CD, Renwick P, Farouk R et al (1996) Suprapubic versus transurethral catheterisation of males undergoing pelvic colorectal surgery. Int J Color Dis 11:177–179

    Article  CAS  Google Scholar 

  19. Regenbogen SE, Read TE, Roberts PL et al (2011) Urinary tract infection after colon and rectal resections: more common than predicted by risk-adjustment models. J Am Coll Surg 213:784–792

    Article  PubMed  Google Scholar 

  20. Sethia KK, Selkon JB, Berry AR et al (1987) Prospective randomized controlled trial of urethral versus suprapubic catheterization. Br J Surg 74:624–625

    Article  CAS  PubMed  Google Scholar 

  21. Vandoni RE, Lironi A, Tschantz P (1994) Bacteriuria during urinary tract catheterization: suprapubic versus urethral route: a prospective randomized trial. Acta Chir Belg 94:12–16

    CAS  PubMed  Google Scholar 

  22. Zaheer S, Pemberton JH, Farouk R et al (1998) Surgical treatment of adenocarcinoma of the rectum. Ann Surg 227:800–811

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Zmora O, Madbouly K, Tulchinsky H et al (2010) Urinary bladder catheter drainage following pelvic surgery—is it necessary for that long? Dis Colon Rectum 53:321–326

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Digestive Surgery, Hôpital Saint-Antoine, Assistance Publique Hôpitaux de Paris, Université Pierre et Marie Curie, Paris VI, 184 rue du Faubourg Saint-Antoine, 75012, Paris, France

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

Authors
  1. Cécile Bouchet-Doumenq
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jérémie H. Lefevre
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Malika Bennis
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Najim Chafai
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Emmanuel Tiret
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Yann Parc
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jérémie H. Lefevre.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Bouchet-Doumenq, C., Lefevre, J.H., Bennis, M. et al. Management of postoperative bladder emptying after proctectomy in men for rectal cancer. A retrospective study of 190 consecutive patients. Int J Colorectal Dis 31, 511–518 (2016). https://doi.org/10.1007/s00384-015-2471-8

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00384-015-2471-8

Keywords

Search

Navigation