Acute Urinary Retention and Urinary Tract Infection after Short-Course Urinary Drainage in Colon or High Rectum Anastomoses: Post Hoc Analysis of a Multicentre Prospective Database from the GRACE Group.

Aurélien Venara (1, 2) , Jean François Hamel (3) , Jean-Marc Régimbeau (4, 5) , Julien Gillet , Jean Joris , Eddy Cotte (6, 7) , Karem Slim (8)

1 Service de Chirurgie Digestive et Endocrinienne [CHU Angers]
2 HIFIH - Hémodynamique, Interaction Fibrose et Invasivité tumorales Hépatiques
3 CHU Angers - Centre Hospitalier Universitaire d'Angers
4 Chirurgie digestive [CHU Amiens]
5 SSPC - Simplification des soins chez les patients complexes - UR UPJV 7518
6 CHLS - Centre Hospitalier Lyon Sud [CHU - HCL]
7 Université de Lyon
8 Service de Chirurgie Digestive et Hépatobiliaire [CHU Clermont-Ferrand]

AIM: The aim was to define the risk factors for acute urinary retention (AUR) and urinary tract infections (UTIs) in colon or high rectum anastomosis patients based on the absence of a urinary catheter (UC) or the early removal of the UC (<24\,h). METHOD: This is a multicentre, international retrospective analysis of a prospective database including all patients undergoing colon or high rectum anastomoses. Patients were part of the enhanced recovery programme audit, developed by the Francophone Group for Enhanced Recovery after Surgery, and were included if no UC was inserted or if a UC was inserted for <24\,h. RESULTS: In all, 9389 patients had colon or high rectum anastomoses using laparoscopy, open surgery or robotic surgery. Among these patients, 4048 were excluded because the UC was left in place >24\,h (43.1%) and 97 were excluded because the management of UC was unknown (1%). Among the 5244 colon or high rectum anastomoses patients included, AUR occurred in 5.2% and UTI occurred in 0.7%. UCs were in place for <24\,h in 2765 patients (52.7%) and 2479 did not have UCs in place (47.3%). Multivariate analysis showed that management of the UC was not significantly associated with the occurrence of AUR and that risk factors for AUR were male gender, ≥q65\,years old, having an American Society of Anesthesiologists score ≥q3 and receiving epidural analgesia. Conversely, being of male gender was a protective factor of UTI, while being ≥q65\,years old, having open surgery and receiving epidural analgesia were risk factors for UTIs. The management of the UC was not significantly associated with the occurrence of UTIs but the occurrence of AUR was a more significant risk factor for UTIs. CONCLUSION: UCs in place for <24\,h did not reduce the occurrence of AUR or UTI compared to the absence of UCs.

Mots clés: *Urinary Retention/etiology/complications; *Urinary Tract Infections/etiology/complications; acute urinary retention; Aged; Anastomosis; Surgical/adverse effects; Colon/surgery; colorectal surgery; Drainage/adverse effects; enhanced recovery programme; Female; Humans; Male; Rectum/surgery; Retrospective Studies; urinary drainage; urinary tract infection

Domaines: Médecine humaine et pathologie

Aurélien Venara, Jean François Hamel, Jean-Marc Régimbeau, Julien Gillet, Jean Joris, et al.. Acute Urinary Retention and Urinary Tract Infection after Short-Course Urinary Drainage in Colon or High Rectum Anastomoses: Post Hoc Analysis of a Multicentre Prospective Database from the GRACE Group.. Colorectal Disease, 2022, 24 (10), pp.1164--1171. ⟨10.1111/codi.16184⟩. ⟨hal-03838387⟩