Postoperative bladder training in patients with mid-low rectal cancer facilitates early removal of the urinary catheter: a prospective, randomized, open-label, blinded-endpoint trial.

BACKGROUND: To evaluate whether intermittent catheterization for bladder training can reduce urinary catheterization duration in patients undergoing mid-low rectal cancer surgery. METHODS: Stratified by gender, 330 patients were divided into a 5-day catheterization control group, and experimental groups A (3-day bladder training) and B (5-day bladder training), with 110 patients each. RESULTS: Two-way ANOVA found that gender affected recatheterization, Pdet@Qmax, Qmax, BOOI and three-day total urine volume. No difference between groups A and B. Patients in experimental group A had a shorter time to first void (P = 0.030) and lower three-day average residual urine volume (P = 0.011) than the control group, and patients in experimental group B had a larger urine volume (P = 0.043) and lower first residual urine volume (P = 0.001). Bladder training reduced recatheterization in males. The nomogram constructed based on the logistic regression model better predicted the risk of urinary tract infection (AUC = 0.669) and recatheterization (AUC = 0.731). These two models may help provide new tools for the postoperative care of patients with mid-low rectal cancer. CONCLUSIONS: Three-day catheter removal after bladder training is non-inferior to five-day removal. Bladder training is effective in reducing the chances of recatheterization in patients with mid-low rectal cancer. TRIAL REGISTRATION: This study was registered with the China Clinical Trials Registry at 22th March, 2018 (No. ChiCTR1800015313, https://www.chictr.org.cn/showproj.html?proj=26123 ).