Postoperative Urinary Retention After Laparoscopic Colorectal Resection with Early Catheter Removal: A Prospective Observational Study.

Background: Early catheter removal is essential to enhance postoperative mobilization and recovery, but may carry a risk of urinary retention. This study aimed to evaluate a standardized regimen for early postoperative catheter removal and re-catheterization in patients undergoing elective laparoscopic colorectal cancer surgery within an optimal ERAS setting.

Methods: This was a single-center prospective study of patients undergoing elective minimally invasive colorectal resection and postoperative catheter removal within 24 h, with a re-catheterization threshold of 800 ml bladder volume. The primary outcome was postoperative urinary retention rate, and the secondary outcomes were time of catheter removal and length of stay with a special focus on differences between colon and rectal resections.

Results: A total of 113 patients were included in the study, and 87 patients were eligible for the final analysis. Rectal resection was performed in 22 of 87 patients, and all operations were performed with minimally invasive technique. The conversion rate was 3.5%, and 30-day mortality was 0%. More than 95% of the patients had their catheter removed within 24 h with no difference between rectal and colonic resections. Postoperative urinary retention was observed in 9% of all patients (rectum 18% vs. colon 6%, p = 0.11). One patient had an indwelling catheter at discharge, but all patients had free voluntary micturition at 30-day follow-up. Median length of stay was 3 days (1-13 days).

Conclusions: Catheter removal within 24 h of surgery using a re-catheterization threshold of 800 ml is safe and reduces unnecessary re-catheterizations following minimally invasive colorectal resection.