Effect of Intermittent Urethral Catheter Clamping Combined With Active Urination Training (ICCAUT) Strategy on Postoperative Re-catheterization Secondary to Urinary Retention After Radical Rectal Cancer Surgery (ICCAUT-2)
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Urinary Retention
- Sponsor
- The First Hospital of Jilin University
- Enrollment
- 1686
- Locations
- 1
- Primary Endpoint
- secondary catheterization owing to urinary retention
- Status
- Withdrawn
- Last Updated
- 8 months ago
Overview
Brief Summary
The objective of this trial is to investigate the effect of bladder training on the incidence of re-catheterization after proctectomy. In this study, the bladder training include intermittent urethral catheter clamping combined with active urination training, which we called ICCAUT strategy. This prospective, single-center, randomized controlled trial will enroll patients with rectal cancer who will be randomized in a 1:1 ratio to the ICCAUT group or the free-drainage group. In the ICCAUT group, patients will undergo intermittent clamping of the urinary catheter before its removal. Each time the catheter is released, we will encourage the patients to actively initiate urination to facilitate complete bladder emptying. While patients in the free-drainage group will not undergo any specific training. The urinary catheter will be removed on the second postoperative day for both groups. The primary endpoint is the incidence of re-catheterization due to urinary retention. Secondary endpoints include urinary tract infection (UTI), time of first urination after catheter removal, residual urine volume after the first urination, postoperative morbidity and mortality within 30 days, as well as urinary function within 30 postoperative days.
Detailed Description
Urinary catheter placement is a standard procedure before proctectomy. However, the necessity of bladder training prior to catheter removal remains uncertain. The objective of this trial is to investigate the effect of bladder training on the incidence of re-catheterization after proctectomy. In this study, the bladder training include intermittent urethral catheter clamping combined with active urination training, which we called ICCAUT strategy. This prospective, single-center, randomized controlled trial will enroll patients with rectal cancer who will be randomized in a 1:1 ratio to the ICCAUT group or the free-drainage group. In the ICCAUT group, patients will undergo intermittent clamping of the urinary catheter before its removal. Each time the catheter is released, we will encourage the patients to actively initiate urination to facilitate complete bladder emptying. While patients in the free-drainage group will not undergo any specific training. The urinary catheter will be removed on the second postoperative day for both groups. The primary endpoint is the incidence of re-catheterization due to urinary retention. Secondary endpoints include urinary tract infection (UTI), time of first urination after catheter removal, residual urine volume after the first urination, postoperative morbidity and mortality within 30 days, as well as urinary function within 30 postoperative days.
Investigators
Yuchen Guo, Ph.D.
Prof.
The First Hospital of Jilin University
Eligibility Criteria
Inclusion Criteria
- •Patients with a confirmed preoperative diagnosis of rectal cancer.
- •Patients with tumors located below the rectosigmoid junction, as determined by preoperative computed tomography (CT) or rectal magnetic resonance imaging (MRI).
- •Patients undergoing laparoscopic or robotic-assisted total mesorectal excision (TME) for rectal cancer.
Exclusion Criteria
- •History of abdominal surgery involving the rectum, sigmoid colon, left hemicolectomy, bladder resection or partial resection, prostate surgery, or hysterectomy.
- •History of urethral injury, cranial surgery, spinal surgery, stroke with limb dysfunction, or Parkinson's disease.
- •Inability to urinate through the urethra preoperatively due to various reasons (e.g., ureteral puncture or ureterostomy).
- •Presence of urinary tract infection preoperatively.
- •Previously diagnosed with bladder overactivity syndrome, urinary retention or voiding dysfunction, or diabetic bladder disease.
- •Concomitant resection of other pelvic organs was performed during surgery, including the bladder, prostate, uterus, cervix, and vagina, except for simple adnexal resection.
- •Lateral lymph node dissection for rectal cancer.
- •Injury to the ureter, bladder, or urethra during the perioperative period.
- •Preoperative renal dysfunction (serum creatinine level \>133 μmol/L).
- •Emergency surgery.
Outcomes
Primary Outcomes
secondary catheterization owing to urinary retention
Time Frame: within 7 days after the first time of urethral catheter removal
The primary endpoint of this study is the rate of secondary catheterization owing to urinary retention until discharge. Secondary catheterization can be performed by urethral catheter insertion or suprapubic puncture. The decision to perform secondary catheterization is based on the specific criteria determined by the clinician.
Secondary Outcomes
- Urinary tract infections(within 1 days after the first time of urethral catheter removal)
- The time to first voiding after catheter removal(within 1 days after the first time of urethral catheter removal)
- The residual urine volume after the first voiding(within 1 days after the first time of urethral catheter removal)
- Graded assessment of catheter-related bladder discomfort (CRBD)(within 1 days after the first time of urethral catheter removal)
- Voiding function(on the second day after the first time of urethral catheter removal, and at the 30th day after surgery)
- Postoperative complications(within 30 days after the operation)