Preoperative urinary function does not predict postoperative acute urinary retention in men after rectal resection.

Area of Science:

• Urology
• Colorectal Surgery

Background:

• Acute urinary retention (AUR) is a recognized complication following rectal surgery, potentially increasing patient morbidity.
• Causes of postoperative AUR are multifactorial, including patient, pathology, and treatment-related elements.
• Men undergoing total mesorectal excision (TME) may have pre-existing urinary issues, raising concerns about postoperative AUR risk.

Purpose of the Study:

• To prospectively evaluate the impact of preoperative urinary function on the occurrence of postoperative AUR in men undergoing TME.

Main Methods:

• A prospective multicenter cohort study included adult men undergoing rectal resection (June 2016-January 2018).
• Exclusions: combined pelvic resections, inability to void, and emergency surgery.
• Preoperative assessment included uroflowmetry, prostate ultrasound, and International Prostate Symptom Score (IPSS). Postoperative AUR, urinary tract infection (UTI), and length of stay (LOS) were recorded.

Main Results:

• Seventy-seven patients (mean age 61) were studied; 21% experienced AUR.
• Preoperative urinary function, IPSS, and urological history did not predict postoperative AUR.
• AUR was not linked to UTI or prolonged LOS. UTI was associated with higher intravesical prostate protrusion.

Conclusions:

• Preoperative urinary dysfunction is not a predictor of postoperative AUR after TME.
• Early voiding trials post-TME are not contraindicated by pre-existing urinary issues.
• Postoperative AUR does not appear to increase UTI risk or LOS.