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

Abstract

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. 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 24h (CR < 24), and removal greater than 24h (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. 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. 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.