Abstract
Background: Voiding dysfunction is frequently observed after rectal resection and justifies urinary
drainage. However, there is no agreement about the optimal duration of this postoperative
drainage. The aim of this controlled trial was to compare 1 versus 5 days of transurethral
catheterization after rectal resection, with special reference to urinary tract infection
and bladder retention. Methods: One hundred twenty-six patients undergoing rectal resection were included in a prospective
randomized study designed to compare the results for patients undergoing 1 day of
transurethral catheterization after rectal resection (1-day group) with those for
patients undergoing 5 days' catheterization (5-day group). Results: Patients were randomly assigned to the 1-day and 5-day groups (n = 64 and 62, respectively).
Clinical findings and surgical procedures were comparable in both groups. Acute urinary
retention occurred in 16 patients (25%) in the 1-day group versus 6 (10%) in the 5-day
group (P < .05). Urinary tract infection was observed in 13 of 64 patients (20%) in the 1-day
group versus 26 of 62 (42%) in the 5-day group (P < .01). Multivariate analysis revealed that after 1 day of catheterization carcinoma
of the low rectum and lymph node metastasis were significant risk factors for acute
urinary retention (P < .05 for both factors). After selection of patients without low rectum carcinoma,
the acute urinary retention rate was comparable in both groups (14% in the 1-day group
versus 7% in the 5-day group), but the urinary tract infection rate was significantly
lower in the 1-day group versus the 5-day group (14% vs 40, P < .01). Conclusions: Our controlled study showed that after rectal resection 1 day of urinary drainage
can be recommended for most patients. Five-day drainage should be reserved for patients
with low rectal carcinoma. (Surgery 1999;125:135-41.)
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Article info
Publication history
Accepted:
September 22,
1998
Footnotes
☆Reprint requests: Yves Panis, MD, PhD, Service de Chirurgie Général et Digestive, Hôpital Lariboisière, 2, rue Ambroise Paré, 75475 Paris Cedex 10, France.
Identification
Copyright
© 1999 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
