Photo Credit: Nadzeya Haroshka
The following is a summary of the study titled “Effect of Incision Location and Type of Fistula on Postoperative Urinary Retention After Radical Surgery for Anal Fistula: A Retrospective Analysis,” published in the October 2024 issue of Gastroenterology by Li et al.
Postoperative urinary retention (POUR) is a common complication following proctology surgeries, including radical surgery for anal fistula. POUR is characterized by an inability to urinate despite a full bladder, and its causes are varied. For this study, researchers aimed to identify the risk factors associated with POUR in patients undergoing radical surgery for anal fistula.
They conducted a retrospective review of the medical records of 511 patients who underwent radical surgery for anal fistula between August 2022 and December 2023. Binary logistic regression analysis was used to identify independent risk factors for POUR.
Of the 511 patients, 57 (11.2%) developed POUR within 48 hours post-surgery, with men being more frequently affected (84.4%). The analysis identified several independent risk factors for POUR: a history of urological disease (OR = 6.048, p < 0.001), incisions at position 1 (OR = 2.228, p = 0.046), high anal fistula (OR = 4.768, p < 0.001), a visual analog scale (VAS) pain score of ≥7 (OR = 2.805, p = 0.010), and a generalized anxiety disorder (GAD-7) score of ≥5 (OR = 2.405, p = 0.024).
The study concluded that POUR is a significant postoperative complication for patients undergoing radical surgery for anal fistula, particularly those with pre-existing urological conditions, high anal fistulas, or anterior rectal fistulas, and those who experience significant postoperative pain and anxiety. Surgeons should focus on surgical techniques for high anal fistulas, closely monitor bladder volume in high-risk patients, and implement strategies to manage postoperative pain and anxiety to reduce the risk of POUR and prevent long-term bladder damage.
Source: bmcgastroenterol.biomedcentral.com/articles/10.1186/s12876-024-03435-0
