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Postoperative Urinary Retention After Laparoscopic Colorectal Resection with Early Catheter Removal: A Prospective
Jens Ravn Eriksen1, Pia Munk-Madsen2, Henrik Kehlet3
1Colorectal Cancer Unit, Department of Surgery, Zealand University Hospital, Roskilde, Sygehusvej 10, 4000, Roskilde, Denmark. jeer@regionsjaelland.dk.
World Journal of Surgery
|April 18, 2019
Summary
Early urinary catheter removal after laparoscopic colorectal surgery is safe. A standardized protocol for catheter removal within 24 hours and re-catheterization at 800 ml bladder volume minimizes urinary retention and improves patient recovery.
Area of Science:
- Colorectal Surgery
- Urology
- Enhanced Recovery After Surgery (ERAS)
Background:
- Early urinary catheter removal is crucial for postoperative mobilization and recovery in colorectal surgery patients.
- However, premature catheter removal may increase the risk of urinary retention.
- Optimizing catheter management is key within Enhanced Recovery After Surgery (ERAS) protocols.
Purpose of the Study:
- To evaluate a standardized regimen for early postoperative urinary catheter removal and re-catheterization.
- To assess the safety and efficacy in patients undergoing elective laparoscopic colorectal cancer surgery.
- To analyze outcomes within an optimal ERAS setting.
Main Methods:
- A single-center prospective study included patients undergoing elective minimally invasive colorectal resection.
- Postoperative urinary catheter removal was planned within 24 hours.
- Re-catheterization was implemented if bladder volume reached 800 ml.
Main Results:
- Over 95% of patients had their catheter removed within 24 hours, with no significant difference between colon and rectal resections.
- The overall postoperative urinary retention rate was 9% (18% for rectal vs. 6% for colon resection, p=0.11).
- Median length of stay was 3 days, with all patients achieving voluntary micturition by 30-day follow-up.
Conclusions:
- A 24-hour urinary catheter removal protocol with an 800 ml re-catheterization threshold is safe and effective.
- This strategy reduces unnecessary re-catheterizations in patients undergoing minimally invasive colorectal resection.
- The protocol supports early mobilization and recovery within ERAS guidelines.
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