Evaluation and Management of Urinary Retention Following Colorectal and Gynecologic Oncologic Surgery

Urinary retention after radical pelvic surgery is a relatively common, well-recognized complication. The primary problem is neural disruption to or from the bladder during curative surgery. Resulting symptoms may include urinary retention presenting post operatively early or late. Other symptoms include overflow incontinence, to controlled stress incontinence, or urinary tract infections. Management is predicated on the clinical history, examination, physical findings and urodynamic evaluations. The principles of neurogenic bladder management are based on management of urinary incontinence or retention, prevention of urinary tract infections, prevention of stone disease and preservation of renal function. While not all patients who undergo radical pelvic surgery for oncological disease, develop neurogenic bladder, it must be considered in patient??s with urinary retention. In men, retention after pelvic surgery may not be caused by BPH, but neurogenic bladder, thus a transurethral resection of prostate may not be the appropriate management. Management of urological complications of pelvic surgery depends on a full neurourological assessment of the patient, and a treatment plan based on objective findings of the complete examination.