Effect of incision location and type of fistula on postoperative urinary retention after radical surgery for anal fistula: a retrospective analysis

• Published in: BMC gastroenterology Vol. 24; no. 1; pp. 367 - 9
• Main Authors: Li, Chen, Liu, Ningyuan, Huang, Zichen, Wei, Zijian, Li, Keyi, Hou, Wenxiao, Ye, Sangyu, Zheng, Lihua
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 14.10.2024; BioMed Central; BMC
• Subjects: Adult; Aged; Anorectal fistula; Care and treatment; Complications; Complications and side effects; Female; High anal fistula; Humans; Male; Medical research; Medicine, Experimental; Middle Aged; Physiological aspects; Postoperative Complications - epidemiology; Postoperative Complications - etiology; Postoperative urinary retention; Radical surgery for anal fistula; Rectal Fistula - etiology; Rectal Fistula - surgery; Retrospective Studies; Risk Factors; Surgery; Surgical Wound - complications; Surgical Wound - etiology; Therapeutics, Surgical; Urinary Retention - epidemiology; Urinary Retention - etiology; Urological disease; China; Postoperative urinary retention; High anal fistula; Radical surgery for anal fistula; Risk factors; Urological disease
• ISSN: 1471-230X; 1471-230X
• DOI: 10.1186/s12876-024-03435-0

Postoperative urinary retention (POUR) is a common complication characterized by fullness of the bladder without the ability to urinate. Its etiology in proctology surgery is multifactorial. This study aimed to identify the risk factors for POUR after radical surgery for anal fistula. We retrospectively reviewed the clinical records of 511 patients who underwent radical surgery for anal fistula at the China-Japan Friendship Hospital from August 2022 to December 2023. Risk factors for POUR were analyzed by means of binary logistic regression analyses. POUR occurred in 57 patients (11.2%) within 48 h post-surgery, and males were predominantly affected (84.4%). Independent risk factors included 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), VAS score ≥ 7 (OR = 2.805; p = 0.010), and GAD-7 score ≥ 5 (OR = 2.405; P = 0.024). POUR is a significant complication post-radical surgery for anal fistula, particularly among patients with urological disease, high anal fistula, and incisions at position 1. Surgeons should pay more attention to surgical methods for high anal fistulas and fistulas in the anterior rectum, and monitor postoperative bladder volume in high-risk patients. Enhanced postoperative pain and anxiety management can reduce the incidence of POUR and prevent long-term bladder damage.