Skip to main content

Advertisement

SpringerLink
Log in

Retrospective risk analysis for acute urinary dysfunction after laparoscopic rectal cancer surgery in patients receiving epidural analgesia

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

Abstract

Purpose

Urinary dysfunction (UD) is a frequent complication following rectal surgery. The aim of the present study was to investigate the risk factors for acute UD after laparoscopic low anterior resection (LALAR) for rectal cancer in patients receiving epidural analgesia.

Methods

A retrospective study was conducted on 131 patients who underwent LALAR among those receiving epidural analgesia in a single institution between October 2008 and December 2019. Univariate and multivariate analyses were performed to determine the clinicopathological factors associated with acute UD.

Results

The overall incidence of acute UD was 16.0% (21/131). Univariate analysis showed that older age (P = 0.016) and earlier urinary catheter removal (P = 0.036) were associated with acute UD. Multivariate logistic regression analysis revealed that older age (10-year increments; odds ratio (OR) 2.046, 95% confidence interval (CI) 1.171–3.543, P = 0.011), urinary catheter removal before epidural analgesia discontinuation (OR 6.393, 95% CI 1.540–26.534, P = 0.011), and a large tumor circumference rate (10% increments; OR 1.263, 95% CI 1.043–1.530, P = 0.017) were independent risk factors for acute UD.

Conclusion

Our findings suggest that older age, early removal of urinal catheter before epidural analgesia discontinuation, and large tumor circumference rate are risk factors of acute UD after LALAR for rectal cancer in patients receiving epidural analgesia.

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. Aly EH (2009) Laparoscopic colorectal surgery: summary of the current evidence. Ann R Coll Surg Engl 91:541–544

    Article  Google Scholar 

  2. O'Donohue PF, Warren CD, Chow CFK (2018) Is laparoscopic rectal surgery really not non-inferior? Mini-invasive Surg 2:24

  3. Havenga K, Maas CP, DeRuiter MC, Welvaart K, Trimbos JB (2000) Avoiding long-term disturbance to bladder and sexual function in pelvic surgery, particularly with rectal cancer. Semin Surg Oncol 18:235–243

    Article  CAS  Google Scholar 

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

    Article  Google Scholar 

  5. Kim HO, Cho YS, Kim H, Lee SR, Jung KU, Chun HK (2016) Scoring systems used to predict bladder dysfunction after laparoscopic rectal cancer surgery. World J Surg 40:3044–3051

    Article  Google Scholar 

  6. Zhao Y, Hou XL, Ding JH, Zhao K, Xu X, Dong GL (2018) Early urinary dysfunction after laparoscopic rectal cancer surgery: does surgeons’ learning curve matter? Am Surg 84:658–666

    Article  Google Scholar 

  7. Hamamoto H, Yamamoto M, Masubuchi S, Ishii M, Osumi W, Tanaka K, Okuda J, Uchiyama K (2019) Male sex and anterior wall tumor location as risk factors for urinary dysfunction after laparoscopic rectal surgery. Surg Endosc 34:3567–3573

  8. Baldini G, Bagry H, Aprikian A, Carli F (2009) Postoperative urinary retention: anesthetic and perioperative considerations. Anesthesiology 110:1139–1157

    Article  Google Scholar 

  9. Coyle D, Joyce KM, Garvin JT, Regan M, McAnena OJ, Neary PM, Joyce MR (2015) Early post-operative removal of urethral catheter in patients undergoing colorectal surgery with epidural analgesia – a prospective pilot clinical study. Int J Surg 16:94–98

    Article  Google Scholar 

  10. Chaudhri S, Maruthachalam K, Kaiser A, Robson W, Pickard RS, Horgan AF (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  Google Scholar 

  11. Hasegawa S, Nagayama S, Nomura A, Kawamura J, Sakai Y (2008) Multimedia article. Autonomic nerve-preserving total mesorectal excision in the laparoscopic era. Dis Colon Rectum 51:1279–1282

    Article  Google Scholar 

  12. Kuroyanagi H, Oya M, Ueno M, Fujimoto Y, Yamaguchi T, Muto T (2008) Standardized technique of laparoscopic intracorporeal rectal transection and anastomosis for low anterior resection. Surg Endosc 22:557–561

    Article  Google Scholar 

  13. Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240:205–213

    Article  Google Scholar 

  14. Weykamp C (2013) HbA1c: a review of analytical and clinical aspects. Ann Lab Med 33:393–400

    Article  CAS  Google Scholar 

  15. Lange MM, Maas CP, Marijnen CA, Wiggers T, Rutten HJ, Kranenbarg EK, van de Velde CJ, Cooperative Clinical Investigators of the Dutch Total Mesorectal Excision T (2008) Urinary dysfunction after rectal cancer treatment is mainly caused by surgery. Br J Surg 95:1020–1028

    Article  CAS  Google Scholar 

  16. Kwaan MR, Lee JT, Rothenberger DA, Melton GB, Madoff RD (2015) Early removal of urinary catheters after rectal surgery is associated with increased urinary retention. Dis Colon Rectum 58:401–405

    Article  Google Scholar 

  17. Bouchet-Doumenq C, Lefevre JH, Bennis M, Chafai N, Tiret E, Parc Y (2016) 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

    Article  Google Scholar 

  18. Ito M, Kobayashi A, Fujita S, Mizusawa J, Kanemitsu Y, Kinugasa Y, Komori K, Ohue M, Ota M, Akazai Y, Shiozawa M, Yamaguchi T, Akasu T, Moriya Y, Colorectal Cancer Study Group of Japan Clinical Oncology G (2018) Urinary dysfunction after rectal cancer surgery: results from a randomized trial comparing mesorectal excision with and without lateral lymph node dissection for clinical stage II or III lower rectal cancer (Japan Clinical Oncology Group Study, JCOG0212). Eur J Surg Oncol 44:463–468

    Article  Google Scholar 

  19. Mari GM, Crippa J, Cocozza E, Berselli M, Livraghi L, Carzaniga P, Valenti F, Roscio F, Ferrari G, Mazzola M, Magistro C, Origi M, Forgione A, Zuliani W, Scandroglio I, Pugliese R, Costanzi ATM, Maggioni D (2019) Low ligation of inferior mesenteric artery in laparoscopic anterior resection for rectal cancer reduces genitourinary dysfunction: results from a randomized controlled trial (HIGHLOW Trial). Ann Surg 269:1018–1024

    Article  Google Scholar 

  20. Toritani K, Watanabe J, Suwa Y, Suzuki S, Nakagawa K, Suwa H, Ishibe A, Ota M, Kunisaki C, Endo I (2019) The risk factors for urinary dysfunction after autonomic nerve-preserving rectal cancer surgery: a multicenter retrospective study at Yokohama Clinical Oncology Group (YCOG1307). Int J Colorectal Dis 34:1697–1703

    Article  Google Scholar 

  21. Stubbs BM, Badcock KJ, Hyams C, Rizal FE, Warren S, Francis D (2013) A prospective study of early removal of the urethral catheter after colorectal surgery in patients having epidural analgesia as part of the Enhanced Recovery After Surgery programme. Colorectal Dis 15:733–736

    Article  CAS  Google Scholar 

  22. Biondi A, Grosso G, Mistretta A, Marventano S, Toscano C, Gruttadauria S, Basile F (2013) Laparoscopic-assisted versus open surgery for colorectal cancer: short- and long-term outcomes comparison. J Laparoendosc Adv Surg Tech A 23:1–7

    Article  Google Scholar 

Download references

Acknowledgments

The authors would like to thank Dr. Keiichiro Okuyama, Dr. Hiroshi Kubo, Dr. Osamu Ikeda, Dr. Atsushi Miyoshi, and Dr. Seiji Sato from the Department of Surgery, Saga Medical Center Koseikan, for treating the patients and useful discussions. We also thank Ms. Shiori Joujima who belongs to Medical Information Division, Life Science Research Institution, Saga Medical Center Koseikan for the data collection.

Availability of data and material

The data sets generated during the study are available from the corresponding author on reasonable request.

Funding

none

Author information

Authors and Affiliations

  1. Department of Surgery, Saga Medical Center Koseikan, 400 Nakabaru, Kasemachi, Saga City, Saga, 849-8571, Japan

    Masatsugu Hiraki, Toshiya Tanaka, Hirofumi Sato & Kenji Kitahara

  2. Life Science Research Institution, Saga Medical Center Koseikan, 400 Nakabaru, Kasemachi, Saga City, Saga, 849-8571, Japan

    Eiji Sadashima

Authors
  1. Masatsugu Hiraki
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Toshiya Tanaka
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Eiji Sadashima
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Hirofumi Sato
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Kenji Kitahara
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

M.H. and T.T. designed this study. M.H., T.T., H.S., and K.K. treated the patients. M.H. and E.S. (specialist in statistics) analyzed the data. M.H. and T.T. interpreted the results and wrote the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Masatsugu Hiraki.

Ethics declarations

Conflicts of interest

The authors declare that they have no conflict of interest.

Ethics approval

The medical ethics committee of Saga Medical Center Koseikan reviewed and approved this study design (permission number 20-03-01-03).

Consent to participate

All patients and their families were informed about the surgical procedure and provided their written consent. Informed broad consent for this study was obtained.

Consent for publication

Informed broad consent for this study was obtained.

Code availability

none

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Hiraki, M., Tanaka, T., Sadashima, E. et al. Retrospective risk analysis for acute urinary dysfunction after laparoscopic rectal cancer surgery in patients receiving epidural analgesia. Int J Colorectal Dis 36, 169–175 (2021). https://doi.org/10.1007/s00384-020-03745-1

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00384-020-03745-1

Keywords

Search

Navigation