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Acute urinary retention rates following early removal or no placement in colon and rectal surgery: a single-center analysis

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Abstract

Background

The adequate duration of urinary drainage following colorectal surgery remains debated. The purpose of this study was to compare acute urinary retention (AUR) rates among various durations of urinary catheterization following colon and rectal surgery.

Methods

We conducted a retrospective analysis of patients undergoing elective colorectal resection enrolled in the Enhanced Recovery After Surgery (ERAS) protocol from 2018 to 2019. Patients were placed into four groups: no catheter placement (NC), catheter removed immediately after surgery (CRAS), removal less than 24 h (CR < 24), and removal greater than 24 h (CR > 24). Our primary endpoint was the rate of AUR in each group. Secondary endpoints included hospital length of stay and urinary tract infections (UTI). A multivariate logistic regression analysis was done to predict AUR.

Results

A total 641 patients were included in this study. 27 patients (4.2%) had NC with an AUR rate of 3.7%. 249 patients (38.8%) had CRAS with an AUR rate of 6.8%. 214 patients (33.4%) had CR < 24 with an AUR rate of 4.2%. 151 patients (23.6%) had CR > 24 with an AUR rate of 2.6%. There was no significant difference in AUR among the groups (p = 0.264). In our multivariant logistic regression, pelvic surgery was an independent risk factor for AUR (p = 0.008). There was a statistically significant higher hospital length of stay (p = 0.001) and rate of UTIs (p = 0.017) in patients with prolonged catheterization.

Conclusion

Deferral or early removal of urinary catheters is safe and feasible following colorectal surgery without a significant increase in AUR. Avoiding prolonged indwelling urinary catheterization may decrease associated complications such as UTI and hospital length of stay.

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Abbreviations

ERAS:

Enhanced recovery after surgery

UTI:

Urinary tract infection

AUR:

Acute urinary retention

BMI:

Body mass index

ASA:

American Society of Anesthesia classification

ml:

Milliliters

NC:

No catheter placement

CRAS:

Catheter removed immediately after surgery

CR < 24:

Catheter removed less than 24 h

CR > 24:

Catheter removed after 24 h

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Acknowledgements

Jeffery L. Cohen MD, Kristina H. Johnson MD, William V. Sardella MD, Kristy T. Thurston MD, Christine M. Bartus MD, Sergio R. Casillas-Romero MD, Rafal Barczak MD. Meeting Presentation: American College of Surgeons, Chicago, IL, October 2020.

Funding

This project did not receive any grants or funding.

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Authors and Affiliations

  1. University of Connecticut School of Medicine, General Surgery Residency, Farmington, CT, USA

    Ashley L. Althoff & Jennifer R. Hale

  2. Department of Surgery, Hartford Healthcare, Hartford, CT, USA

    Constantine M. Poulos & Paul V. Vignati

  3. Department of Research, Hartford Healthcare, Hartford, CT, USA

    Ilene Staff

  4. Department of General Surgery, University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT, 06030-8073, USA

    Ashley L. Althoff

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  1. Ashley L. Althoff
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Correspondence to Ashley L. Althoff.

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Ashley L. Althoff, Constantine M. Poulos, Paul V. Vignati, Jennifer R. Hale and Ilene Staff have no conflicts of interest or financial ties to disclose.

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Althoff, A.L., Poulos, C.M., Hale, J.R. et al. Acute urinary retention rates following early removal or no placement in colon and rectal surgery: a single-center analysis. Surg Endosc 36, 3116–3121 (2022). https://doi.org/10.1007/s00464-021-08613-9

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  • DOI: https://doi.org/10.1007/s00464-021-08613-9

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