Abstract | BACKGROUND:
Urethral catheter (UC) removal is often delayed following colorectal resection due to the perceived increased risk of post-operative urinary retention (POUR) in patients with post-operative epidural analgesia ( POEA). We aimed to determine if UC removal at 48 h, irrespective of ongoing POEA use, altered the risk of POUR and other morbidities associated with urethral catheterisation and immobility. METHODS: We performed a prospective randomised controlled pilot clinical study. Eligible patients were randomised to an experimental arm, SG1 (UC removal 48 h post-operatively), or a control arm, SG2 (UC removed following cessation of POEA). Rates of POUR, urinary tract infection (UTI), pulmonary complications and surgical site infection (SSI) were recorded. Forty-four patients were recruited (SG1: n = 22; SG2: n = 22). RESULTS: No females developed POUR, while it occurred in three males (20%) in SG1 and 2 males (22.2%) in SG2. All patients who developed POUR had undergone rectal resection. Males in SG1 were not at significantly increased risk of POUR compared to those in SG2 (R.R 0.875, p = 1). No patient developed UTI post-operatively. The rate of pulmonary complications (SG1: n = 2; SG2: n = 3, p = 0.229) and SSI (SG1: n = 5; SG2: n = 2, p = 0.146) were similar between both study arms. DISCUSSION: Males undergoing rectal surgery appear to be at increased risk of developing POUR in the presence of epidural analgesia, independent of the timing of UC removal. CONCLUSIONS: All female patients undergoing colorectal resection and male patients undergoing colonic resection may have their urethral catheter removed at 48 h irrespective of use of POEA. CLINICAL TRIALS REGISTRATION NUMBER: NCT01508767 (http://www.clinicaltrials.gov).
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Authors | David Coyle, Kenneth M Joyce, Joseph T Garvin, Mark Regan, Oliver J McAnena, Peter M Neary, Myles R Joyce |
Journal | International journal of surgery (London, England)
(Int J Surg)
Vol. 16
Issue Pt A
Pg. 94-98
(Apr 2015)
ISSN: 1743-9159 [Electronic] England |
PMID | 25769395
(Publication Type: Journal Article, Randomized Controlled Trial)
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Copyright | Copyright © 2015 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved. |
Topics |
- Adult
- Aged
- Aged, 80 and over
- Analgesia, Epidural
- Colon
(surgery)
- Device Removal
- Female
- Humans
- Male
- Middle Aged
- Pilot Projects
- Prospective Studies
- Rectum
(surgery)
- Time Factors
- Urinary Catheterization
(adverse effects)
- Urinary Retention
(etiology)
- Urinary Tract Infections
(etiology)
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