URINARY DYSFUNCTION AND SUBSEQUENT RENAL IMPAIRMENT AFTER SURGERY FOR LOW RECTAL CANCER: A RETROSPECTIVE COHORT STUDY waheebradman@yahoo.com

 

URINARY DYSFUNCTION AND SUBSEQUENT RENAL IMPAIRMENT AFTER SURGERY FOR LOW RECTAL CANCER: A RETROSPECTIVE COHORT STUDY

1

Yemen

Oral only

Urinary dysfunction (UD) is a common, underrecognized complication after lower rectal cancer (LRC) surgery, affecting up to 59% of patients. It can cause retention, infections, and renal impairment. This study explores the link between postoperative UD and renal function decline, emphasizing proactive management.

Methods: A retrospective study of 83 patients undergoing curative LRC resection (April 2015-December 2019) defined UD as post-void residual urine >400 mL, measured within 10 minutes via ultrasound using the prolate ellipsoid formula. Catheterization was indicated for bladder volumes >300 mL (symptomatic) and >500 mL (asymptomatic). Renal function was evaluated by comparing eGFR and CKD incidence (eGFR < 60 mL/min/1.73 m²) between UD and non-UD groups over three years.

Results: UD developed in 21 patients (25%), who were older (70 vs. 61 years, p = 0.007), had longer surgeries (417 vs. 346 minutes, p = 0.03), and more frequent lymph node dissection (47.6% vs. 12.9%, p = 0.002). UD was linked to lower eGFR (60.6 vs. 70.1 mL/min/1.73 m², p = 0.04) and higher CKD incidence (47% vs. 19%, p = 0.02). Complications were more frequent in the UD group (19% vs. 2%, p = 0.01). UD (OR = 3.27, p = 0.046) and hypertension (OR = 5.49, p = 0.006) independently predicted CKD.

Conclusion: Postoperative UD significantly increases CKD risk in LRC patients. Early detection, routine bladder scanning, and timely intervention may help reduce long-term renal complications.