Department of Anesthesiology, West China Hospital of Sichuan University, Chengdu, 610041, China.
Department of Anesthesiology, Panzhihua Central Hospital, Panzhihua, 617067, China.
BMC Anesthesiol. 2024 Aug 5;24(1):272. doi: 10.1186/s12871-024-02652-0.
Postoperative urinary retention (POUR) is a common complication of anorectal surgery. This study was to determine the incidence of POUR in anorectal surgery for benign anorectal diseases, identify its risk factors, and establish a nomogram for prediction of POUR.
A nested case-control study was conducted. The clinical data of patients were collected, and the incidence of POUR was analyzed. Univariate analysis was used to identify the risk factors associated with POUR, and multivariate logistic regression analysis was used to determine independent risk factors for POUR. A nomogram for the preoperative prediction of POUR using a logistic regression model was developed (n = 609).
The incidence of POUR after anorectal surgery for benign anorectal diseases was 19.05%. The independent risk factors for POUR were: female (P = 0.007); male with benign prostatic hyperplasia (BPH) (P = 0.001); postoperative visual analogue scale (VAS) score > 6 (P = 0.002); patient-controlled epidural analgesia (PCEA) (P = 0.016); and a surgery time > 30 min (P = 0.039). In the nomogram, BPH is the most important factor affecting the occurrence of POUR, followed by a postoperative VAS score > 6, PCEA, surgery time > 30 min, and sex has the least influence.
For patients undergoing anorectal surgery for benign anorectal diseases, preventive measures can be taken to reduce the risk of POUR, taking into account the following risk factors: female or male with BPH, severe postoperative pain, PCEA, and surgery time > 30 min. Furthermore, we developed and validated an easy-to-use nomogram for preoperative prediction of POUR in anorectal surgery for benign anorectal diseases.
China Clinical Trial Registry: ChiCTR2000039684, 05/11/2020.
术后尿潴留（POUR）是肛肠手术的常见并发症。本研究旨在确定肛肠良性疾病手术中 POUR 的发生率，识别其危险因素，并建立预测 POUR 的列线图。
采用巢式病例对照研究。收集患者的临床资料，分析 POUR 的发生率。采用单因素分析识别与 POUR 相关的危险因素，采用多因素 logistic 回归分析确定 POUR 的独立危险因素。使用 logistic 回归模型建立术前预测 POUR 的列线图（n=609）。
肛肠良性疾病手术后 POUR 的发生率为 19.05%。POUR 的独立危险因素为：女性（P=0.007）；男性合并良性前列腺增生（BPH）（P=0.001）；术后视觉模拟评分（VAS）>6（P=0.002）；患者自控硬膜外镇痛（PCEA）（P=0.016）；手术时间>30min（P=0.039）。在列线图中，BPH 是影响 POUR 发生的最重要因素，其次是术后 VAS>6、PCEA、手术时间>30min，而性别影响最小。
对于接受肛肠良性疾病手术的患者，可考虑以下危险因素采取预防措施以降低 POUR 的风险：女性或男性合并 BPH、术后疼痛剧烈、使用 PCEA、手术时间>30min。此外，我们还开发并验证了一种用于肛肠良性疾病手术前预测 POUR 的易于使用的列线图。
中国临床试验注册中心：ChiCTR2000039684，2020 年 05 月 11 日。
