Male sex and anterior wall tumor location as risk factors for urinary dysfunction after laparoscopic rectal surgery



Total mesorectal excision (TME) has decreased the local recurrence rate and improved the overall survival of rectal cancer patients. However, urinary dysfunction remains a clinical problem after rectal cancer surgery. The aim was to assess the risk factors for postoperative urinary dysfunction.


This study was a single-center, retrospective analysis of 104 patients who underwent laparoscopic rectal surgery between November 2016 and October 2017. Postoperative urinary dysfunction was defined as the need for urinary catheter re-insertion or the presence of residual urine (≥ 150 mL) postoperatively.


Postoperative urinary dysfunction was seen in 18 patients (17%). Multivariate analysis showed that male sex (odds ratio 3.89, p = 0.034) and anterior wall tumor location (odds ratio = 4.07, p = 0.037) were the predictors of postoperative urinary dysfunction. Compared with patients without risk factors, those with the two risk factors needed longer hospital stays (16 days vs. 30 days, p = 0.0022).


Male sex and anterior wall tumor location were the risk factors for urinary dysfunction after laparoscopic rectal surgery.

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Correspondence to Hiroki Hamamoto.

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Drs. Hiroki Hamamoto, Masashi Yamamoto, Shinsuke Masubuchi, Masatsugu Ishii, Wataru Osumi, Keitaro Tanaka, Junji Okuda, and Kazuhisa Uchiyama have no conflicts of interest or financial ties to disclose.

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Hamamoto, H., Yamamoto, M., Masubuchi, S. et al. Male sex and anterior wall tumor location as risk factors for urinary dysfunction after laparoscopic rectal surgery. Surg Endosc 34, 3567–3573 (2020).

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  • Postoperative urinary dysfunction
  • Laparoscopic rectal surgery
  • Pelvic plexus
  • Neurovascular bundle