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

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  • 1Surgical Outcomes Research Centre (SOuRCe), Sydney Local Health District, University of Sydney, Sydney, New South Wales, Australia.

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Preoperative urinary dysfunction does not predict acute urinary retention (AUR) after rectal surgery (TME). Early voiding trials after TME are safe, as AUR does not increase infection risk or hospital stay.

Keywords:
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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.