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The risk factors of acute urinary retention after laparoscopic colorectal cancer surgery in elderly patients receiving epidural analgesia

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purpose

Urinary retention (UR) is a frequent complication following laparoscopic colorectal surgery. The aim of the present study was to investigate the risk factors for acute UR after laparoscopic surgery for colorectal cancer in patients receiving epidural analgesia.

Methods

A retrospective study was conducted of 201 patients who underwent laparoscopic surgery for colorectal cancer among those receiving epidural analgesia. Univariate and multivariate analyses were performed to determine the clinicopathological factors associated with acute UR. Acute UR was defined as Clavien-Dindo classification grade ≥ 1.

Results

The overall incidence of acute UR was 17.9% (36/201). The univariate analysis showed that male gender (P = 0.043), a history of chronic heart failure (P = 0.009), an increased level of serum creatinine (P = 0.028), an increased intraoperative fluid volume (P = 0.016), and an early postoperative date of urinary catheter removal (P = 0.003) were both associated with acute UR. The multivariate logistic regression analysis revealed an increased intraoperative fluid volume (100-ml increments; odds ratio [OR]: 1.085, 95% confidence interval [CI]: 1.034–1.138, P < 0.001), history of chronic heart failure (OR: 6.843, 95% CI: 1.893–24.739, P = 0.003), and postoperative date of urinary catheter removal (OR: 0.550, 95% CI: 0.343–0.880, P = 0.013) were independent risk factors for acute UR.

Conclusion

Our findings suggest that an increased intraoperative fluid volume, history of chronic heart failure, and early removal of the urinary catheter are risk factors of UR after laparoscopic surgery for colorectal cancer in patients receiving epidural analgesia. An assessment using these factors might be helpful for predicting acute UR.

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Data availability

The data sets generated during the study are available from the corresponding author on reasonable request.

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Acknowledgements

The authors would like to thank Dr. Kumpei Yukimoto, Dr. Keiichiro Okuyama, Dr. Hiroshi Kubo, Dr. Hiroki Koga, Dr. Osamu Ikeda, Dr. Atsushi Miyoshi, and Dr. Seiji Sato who all belong to Department of Surgery, Saga Medical Center Koseikan, Saga, Japan for treating the patients and useful discussions. We also thank Ms. Shiori Johjima who belongs to Medical Information Division, Life Science Research Institution, Saga Medical Center Koseikan, Saga, Japan for the data collection.

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Authors and Affiliations

  1. Department of Surgery, Saga Medical Center Koseikan, 400 Nakabaru, Kasemachi, Saga City, Saga, 840-8571, Japan

    Masatsugu Hiraki, Toshiya Tanaka, Hirofumi Sato & Kenji Kitahara

  2. Life Science Research Institution, Saga Medical Center Koseikan, 400 Nakabaru, Kasemachi, Saga City, Saga, 840-8571, Japan

    Masatsugu Hiraki & Eiji Sadashima

Authors
  1. Masatsugu Hiraki
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  2. Toshiya Tanaka
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  3. Eiji Sadashima
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  4. Hirofumi Sato
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  5. Kenji Kitahara
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Contributions

M Hiraki and T Tanaka designed this study. M Hiraki, T Tanaka, H Sato, and K Kitahara treated the patients. M Hiraki and E Sadashima (specialist in statistics) analyzed the data. M Hiraki and T Tanaka interpreted the results and wrote the manuscript.

Corresponding author

Correspondence to Masatsugu Hiraki.

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Ethics approval

The medical ethics committee of Saga Medical Center Koseikan reviewed and approved this study design (permission number: 21-01-01-07).

Consent to participate

All patients and their families were informed about the surgical procedure and provided their written consent. Informed broad consent for this study was obtained.

Consent for publication

Informed broad consent for this study was obtained.

Conflict of interest

The authors declare no competing interests.

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Hiraki, M., Tanaka, T., Sadashima, E. et al. The risk factors of acute urinary retention after laparoscopic colorectal cancer surgery in elderly patients receiving epidural analgesia. Int J Colorectal Dis 36, 1853–1859 (2021). https://doi.org/10.1007/s00384-021-03938-2

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  • DOI: https://doi.org/10.1007/s00384-021-03938-2

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