Predictors of postoperative urinary retention following colorectal surgery performed within an enhanced recovery programme
Andrew Currie, Christopher Limb, Jayne Mundy & Khurrum Baig
Department of Colorectal Surgery, Worthing Hospital
Enhanced recovery programme guidelines for colorectal surgery suggest routine urinary catheterisation with early removal to prevent urinary tract infection (UTI) and hasten functional recovery. The aim of this study was to identify risk factors for urinary retention following colorectal surgery.
A prospectively collated colorectal enhanced recovery programme dataset was examined from January 2016 to December 2017. Demographic data, clinicopathological variables, previous urological clinic attendance, analgesic method and postoperative outcomes were analysed. Risk factors for postoperative acute urinary retention (AUR) were identified through binary logistic regression.
252 consecutive patients were included in the study cohort. Of these, 16 patients (6.3%) developed postoperative AUR. Males were more likely to developed postoperative AUR (14/131; 10.3%) compared to females (2/121; 1.7%). Patients developing acute postoperative urinary retention had substantially longer postoperative stay (Median(IQR) AUR: 13(8-14) vs No-AUR: 6(6-7)). Multivariate analysis identified male gender (odds ratio(OR) 7.75; 95% CI, 1.52 – 39.57; P = 0.014), previous urology clinic attendance (OR 4.56; 95% CI, 1.27 – 16.44; P = 0.020) and regular opiate analgesia (OR 4.08; 95% CI, 1.14-14.62; P = 0.031) as independent risk factors for postoperative AUR.
Male gender, previous urology clinic attendance and regular opiate analgesia were independent risk factors for postoperative AUR which was associated with a substantial impediment for functional recovery. Improvements in functional recovery may be seen through quality improvement initiatives focussed on these factors.