Optimal Duration of Urinary Catheterization After Total Mesorectal Excision
University of Southern California
Summary
This study is being conducted to determine the length of time a urinary catheter is needed to drain urine from the bladder after colorectal surgery. Urinary retention is a well known complication after pelvic colorectal surgery, and current practice is to continue urinary catheterization for 3- days following pelvic colorectal surgery in an effort to avoid this complication. However, prolonged urinary catheterization is associated with increased risk of urinary tract infections as well as longer hospital stays. The investigators hypothesize that postoperative urinary catheters may be safely removed on postoperative day 1 without increased urinary retention rates. The purpose of this study is to evaluate whether a shorter duration of urinary catheterization (1 day) is non-inferior when compared to standard duration (3 days) in regards to postoperative urinary retention. The investigators plan to perform a prospective, randomized, non-inferiority trial comparing the urinary catheter duration of 1 day and 3 days with the primary endpoint of postoperative urinary retention. Secondary endpoints are urinary tract infection and length of hospital stay. The participants will be randomly assigned to the control group (catheter removal on postoperative day 3) or the experimental group (catheter removal on postoperative day 1).
Description
Disease Background: Total mesorectal excision can be associated with transient post-operative urinary retention due to surgical disruption of pelvic autonomic nerves during procedure. These patients receive intra-operative urinary catheter to prevent post-operative urinary retention. However, the optimal duration for post-operative urinary catheter is not known, and longer duration of urinary catheter is associated with increased morbidity, such as urinary tract infection. A previous prospective randomized controlled trial from 1999 looking at this subject showed an increased rate of postoper…
Eligibility
- Age range
- 18+ years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: * Elective procedures involving total mesorectal excision, including low anterior resection and abdominoperineal resection for rectal cancer as well as proctectomy for inflammatory bowel disease. * All approaches (open, laparoscopic and robotic) will be included, as the approaches not differ in the total mesorectal excision technique. * Patients who received neoadjuvant chemotherapy and/or radiation treatments will be included. * Age ≥ 18 years. * American Society of Anesthesiologists (ASA) class I-III. * Ability to understand and the willingness to sign a written informed…
Interventions
- OtherUrinary catheter removal on postoperative day 1
Urinary catheter will be removed on day 1 (experimental) instead of day 3 (standard of care).
- OtherUrinary catheter removal on postoperative day 3
Urinary catheter will be removed on day 3 (standard of care)
Locations (2)
- Keck Hospital of USCLos Angeles, California
- Los Angeles County Hospital (LAC/USC)Los Angeles, California