What is the role of catheters following colon resection (colectomy)?

Updated: Apr 05, 2021
  • Author: David E Stein, MD, MHCM; Chief Editor: Vikram Kate, FRCS, MS, MBBS, PhD, FACS, FACG, FRCS(Edin), FRCS(Glasg), FIMSA, MAMS, MASCRS, FFST(Ed)  more...
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Answer

In most cases, indwelling urinary catheters can be removed the day after the procedure. However, for patients who have undergone LAR, APR, or ileal pouch–anal anastomosis (IPAA), the urinary catheter ought not to be discontinued until at least postoperative day 2. The reason why these patients need additional time for indwelling catheterization is that these operations are more likely to disrupt the autonomic nerves that innervate the pelvic viscera. [32]

If a patient is unable to void 6 hours after urinary catheter removal, bladder ultrasonography must be performed immediately. An estimated urine volume of 200 mL or greater would be grounds for recatheterization, via either a Foley or a straight catheter. In some instances, urinary retention may present as overflow incontinence. Patients with diabetes or benign prostatic hyperplasia are especially prone to overflow incontinence, the former because of autonomic neuropathy and the latter owing to mechanical obstruction of outflow from the bladder.

Overflow incontinence typically presents as a constant dribbling of urine or frequent urination of small amounts. In such cases, the patient may still be discharged from the hospital but with a Foley catheter left in place and a urine bag attached to the leg. Thorough evaluation of the patient's ability to empty the bladder, along with assistance from a urologist, is essential to the patient's postoperative progress.


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