Etiology and treatment of urinary retention following mixed hemorrhoid surgery: a review
XIONG Yi1, CHEN Jinlan2, NI Jing1, WANG Cong1, XU Li1
1. Department of Anorectal Surgery, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang 310006, China; 2. The First School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang 310053, China
Abstract：Postoperative urinary retention is a common complication after mixed hemorrhoid surgery, referring to the inability of urine in the bladder to be normally expelled, leading to urine retention. This condition not only prolongs the postoperative recovery time and increases medical costs, but may also cause problems such as urinary tract infections and bladder dysfunction. The pathogenesis of urinary retention after mixed hemorrhoid surgery is complex, involving multiple factors such as the type of surgery, anesthesia method, individual differences among patients, postoperative pain management and psychological stress. Although there are various clinical treatment methods, their efficacy varies among individuals. This article reviews relevant literature from 2018 to 2024, analyzing the etiology of urinary retention after mixed hemorrhoid surgery. It summarizes the intervention measures and mechanisms of non-pharmacological treatments, such as physical therapy and analgesic techniques, as well as pharmacological treatments, including anticholinesterase drugs, selective α-receptor blockers and analgesics drugs, so as to provide the reference for the prevention and treatment of urinary retention after mixed hemorrhoid surgery.
[1] CHANGCHIEN C R,YEH C Y,HUANG S T,et al.Postoperative urinary retention after primary colorectal cancer resection via laparotomy:a prospective study of 2 355 consecutive patients[J].Dis Colon Rectum,2007,50(10):1688-1696. [2] 何媛明,曾兰丹,梁家芝,等.预防混合痔术后尿潴留的中西医研究进展[J].内蒙古中医药,2017,36(18):121-122. HE Y M,ZENG L D,LIANG J Z,et al.Advances in Chinese and Western medicine research on preventing postoperative urinary retention after mixed hemorrhoid surgery[J].Inner Mongolia J Trait Chin Med,2017,36(18):121-122.(in Chinese) [3] SMITH D R M,POUWELS K B,HOPKINS S,et al.Epidemiology and health-economic burden of urinary-catheter-associated infection in English NHS hospitals:a probabilistic modelling study[J].J Hosp Infect,2019,103(1):44-54. [4] 魏琦. 对比选择性痔上黏膜切除术(TST)、吻合器痔上黏膜环切术(PPH)治疗混合痔术后的并发症情况及肛肠动力恢复效果[J].中国医疗器械信息,2021,27(12):72-73,132. WEI Q.To compare the postoperative complications of selective superior hemorrhoidectomy(TST)and stapler superior mucosal loop hemorrhoidectomy(PPH)for mixed hemorrhoids and the anorectal dynamic recovery effect[J].China Medical Device Inf,2021,27(12):72-73,132.(in Chinese) [5] 许桂祥,徐丽,周衍照,等.SC-TST与PPH治疗环状痔的临床效果对比分析研究[J].结直肠肛门外科,2022,28(5):465-468. XU G X,XU L,ZHOU Y Z,et al.Comparison study of SC-TST and PPH in the treatment of circumferential mixed hemorrhoids[J].J Colorectal & Anal Surg,2022,28(5):465-468.(in Chinese) [6] ZHANG G X,LIANG R W,WANG J,et al.Network meta-analysis of randomized controlled trials comparing the procedure for prolapse and hemorrhoids,Milligan-Morgan hemorrhoidectomy and tissue-selecting therapy stapler in the treatment of grade Ⅲ and Ⅳ internal hemorrhoids(meta-analysis)[J].Int J Surg,2020,74:53-60. [7] LIU B,CHEN Y L,ZHANG P,et al.Risk factors for postoperative urinary retention in patients underwent surgery for benign anorectal diseases:a nested case-control study[J].BMC Anesthesiol,2024,24(1):272-281. [8] BRACEY D N,HEGDE V,POLLET A K,et al.Incidence and predictive risk factors of postoperative urinary retention after primary total knee arthroplasty[J].J Arthroplasty,2021,36(Suppl. 7):345-350. [9] 矫恒涛,谢凯.选择性痔上黏膜切除术治疗混合痔的安全性及对预后的影响分析[J].生命科学仪器,2024,22(3):53-55. JIAO H T,XIE K.Analysis of the safety and prognostic effects of selective stapled hemorrhoidopexy for mixed hemorrhoids[J].Life Sci Instruments,2024,22(3):53-55.(in Chinese) [10] 张智安,袁琳,闫霞.连续硬膜外麻醉与蛛网膜下腔麻醉在剖宫产麻醉中的应用效果比较[J].贵州医药,2022,46(5):723-724. ZHANG Z A,YUAN L,YAN X.Comparison of the application effect of continuous epidural anesthesia and subarachnoid anesthesia in cesarean delivery anesthesia[J].Guizhou Medical J,2022,46(5):723-724.(in Chinese) [11] LU H X,CAI M,ZHOU D X,et al.The effect of bupivacaine on analgesia and safety in patients undergoing hemorrhoidectomy:a meta-analysis[J/OL].Front Pharmacol,2023[2024-12-25].https://pubmed.ncbi.nlm.nih.gov/38751500.DOI:10.3389/fphar.2023.133196. [12] 刘洁,李西羊,高琴琴,等.蛛网膜下腔麻醉与硬膜外麻醉用于混合痔PPH的临床效果分析[J].检验医学与临床,2024,21(8):1141-1144. LIU J,LI X Y,GAO Q Q,et al.Clinical effect analysis of subarachnoid anesthesia and epidural anesthesia for PPH of mixed hemorrhoids[J].Lab Med Clin,2024,21(8):1141-1144.(in Chinese) [13] 廖欢欢,林世强,林威,等.混合痔患者术后发生尿潴留的影响因素分析[J].中国当代医药,2024,31(6):33-36. LIAO H H,LIN S Q,LIN W,et al.Analysis of influencing factors of postoperative urinary retention in patients with mixed hemorrhoids[J].China Mod Med,2024,31(6):33-36.(in Chinese) [14] 张惊涛. 基于Logistic回归分析环状混合痔患者术后尿潴留发生的危险因素[J].四川生理科学杂志,2024,46(2):420-422. ZHANG J T.Risk factors of postoperative urinary retention in patients with annular mixed hemorrhoids were analyzed based on Logistic regression[J].Sichuan J Physiological Sci,2024,46(2):420-422.(in Chinese) [15] CHEN Y L,LI L,SHI Y X,et al.Evaluating the effectiveness of early urethral catheter removal combined with intermittent catheterization for promoting early recovery of bladder function after laparoscopic radical hysterectomy:a study protocol for a randomized controlled trial[J].Trials,2024,25(1):422-431. [16] 陈小明,胡饶,万顺,等.混合痔外剥内扎切除术后发生尿潴留的危险因素及其预测模型的构建[J].武警医学,2024,35(7):602-606. CHEN X M,HU R,WAN S,et al.Risk factors of urinary retention after external stripping and internal ligation of mixed hemorrhoids and construction of a prediction model[J].Medical J Chin People's Armed Police Force,2024,35(7):602-606.(in Chinese) [17] VUTHIWONG J,WHALEN S,LG Q,et al.Clinical features and sequelae of detrusor underactivity:a study of possible cause and effect[J].World J Urol,2024,42(1):562-568. [18] XUE B,KADEERHAN G,SUN L B,et al.Circulating exosomal miR-16-5p and let-7e-5p are associated with bladder fibrosis of diabetic cystopathy[J].Sci Rep,2024,14(1):837-852. [19] SALVI F,PETRINO R,CONROY S P,et al.Constipation:a neglected condition in older emergency department patients[J].Intern Emerg Med,2024,19(7):1977-1986. [20] 温岚. 混合痔手术患者术后尿潴留发生的相关危险因素分析[J].中国医学创新,2023,20(2):151-154. WEN L.Analysis of risk factors for postoperative urinary retention in mixed hemorrhoid surgery patients[J].Medical Innov China,2023,20(2):151-154.(in Chinese) [21] KAVEH H,MOHAMMAD A,BEHZAD F K,et al.Preoperative tamsulosin effect on postoperative urinary retention following spinal surgery:a randomized controlled trial[J].Int J Surg Open,2023,61:1-6. [22] LIM S,BAZYDLO M,MACKI M,et al.Validation of the benefits of ambulation within 8 hours of elective cervical and lumbar surgery:a Michigan Spine Surgery Improvement Collaborative Study[J].Neurosurgery,2022,91(3):505-512. [23] 梁永华,陈晓丹,郭燕玲.四子散热敷结合膀胱区穴位按摩治疗腰椎间盘突出症消融术后尿潴留的疗效观察[J].中医外治杂志,2022,31(4):80-81. LIANG Y H,CHEN X D,GUO Y L.Observation on the efficacy of hot compresses of Sizi San combined with acupressure in bladder area in the treatment of urinary retention after ablation of lumbar intervertebral disc herniation[J].J External Ther TCM,2022,31(4):80-81.(in Chinese) [24] LU Z H,WANG Q,SUN X D,et al.Transcutaneous electrical acupoint stimulation before surgery reduces chronic pain after mastectomy:a randomized clinical trial[J].J Clin Anesth,2021,74:1-7. [25] BOUSABBEH A,KETATA S,SAHNOUN N,et al.The effect of dexamethasone as an adjuvant in spinal anesthesia for femur upper extremity surgery:a prospective randomized trial[J/OL].Pan Afr Med J,2022[2024-12-25].https://pubmed.ncbi.nlm.nih.gov/36451722.DOI:10.11604/pamj.2022.43.29.36117. [26] 钟强,陈新刚,余海珠.双侧阴部神经阻滞联合硬膜外麻醉用于混合痔手术的疗效观察[J].中国肛肠病杂志,2023,43(6):44-46. ZHONG Q,CHEN X G,YU H Z.The efficacy observation of bilateral pudendal nerves blockade the efficacy observation of bilateral pudendal nerves blockade[J].Chin J Coloproctol,2023,43(6):44-46.(in Chinese) [27] 黄贞玲,陈洁茹,黄萍,等.布比卡因脂质体在术后镇痛中的应用[J].国际麻醉学与复苏杂志,2024,45(4):407-413. HUANG Z L,CHEN J R,HUANG P,et al.Application of liposomal bupivacaine in postoperative analgesia[J].Int J Anesth Resus,2024,45(4):407-413.(in Chinese) [28] SEVIM M,ALKIS O,KARTAL I G,et al.Comparison of transcutaneous tibial nerve stimulation versus percutaneous tibial nerve stimulation in category IIIB chronic prostatitis/chronic pelvic pain syndrome:a randomized prospective trial[J].Prostate,2023,83(8):751-758. [29] CHEN Q L,LI N,WU Y.Neostigmine for postoperative surgical urine retention:a systematic review and meta-analysis[J].Adv Clin Exp Med,2024,33(5):435-444. [30] 王俊虎,耿泽振,杨晓艳.针刺联合甲硫酸新斯的明注射液对产后尿潴留患者排尿情况、膀胱残余尿量及盆底肌张力的影响[J].河北中医,2024,46(9):1516-1519. WANG J H,GENG Z Z,YANG X Y.Effects of acupuncture combined with neostigmine on urination,bladder residual urine volume and pelvic floor muscle tension in patients with postpartum urinary retention[J].Hebei J TCM,2024,46(9):1516-1519.(in Chinese) [31] 廖淑英. 坦索罗辛对腰硬联合麻醉痔上黏膜环切术患者排尿功能的影响[J].医疗装备,2021,34(7):97-98. LIAO S Y.Effects of tamsulosin on urinary function in patients undergoing stapled hemorrhoidopexy under combined spinal-epidural anesthesia[J].Medical Equip,2021,34(7):97-98.(in Chinese) [32] GHUMAN A,DAWIDEK M T,ATHWAL M S,et al.Prophylactic tamsulosin and urinary retention rates following elective colorectal surgery:a retrospective cohort study[J].Int J Colorectal Dis,2022,37(1):209-214. [33] 魏永强,刘守卫,成红雨.氟比洛芬酯复合舒芬太尼、托烷司琼用于假体隆乳术后镇痛的临床效果[J].中国医疗美容,2024,14(2):46-49. WEI Y Q,LIU S W,CHENG H Y.Clinical effect of flurbiprofenate axetil combined with sufentanil and tropansetron for postoperative analgesia after breast implant augmentation[J].China Med Cosmetol,2024,14(2):46-49.(in Chinese) [34] 魏荣秀,邱玉珍,李金龙.对比分析双氯芬酸钠栓纳肛联合肛周亚甲蓝注射在肛肠病术后镇痛效果[J].北方药学,2023,20(3):82-84. WEI R X,QIU Y Z,LI J L.Comparative analysis of analgesic effect of diclofenac sodium suppository combined with perianal methylene blue injection in postoperative analgesia of anorectal diseases[J].J North Pharmacy,2023,20(3):82-84.(in Chinese) [35] HAN J W,OH A Y,JEON Y T,et al.Quality of recovery after laparoscopic cholecystectomy following neuromuscular blockade reversal with neostigmine or sugammadex:a prospective,randomized,controlled trial[J].J Clin Med,2021,10(5):938-948. [36] VALENCIA MORALES D J,STEWART B R,HELLER S F,et al.Urinary retention following inguinal herniorrhaphy:role of neuromuscular blockade reversal[J].Surg Laparosc Endosc Percutan Tech,2021,31(5):613-617.
