Influencing factors and prediction model of urinary retention in patients with rectal cancer after radical resection

Tong Yanmei; Zhang Guiping; Don Wen; Wang Zhi; Zhou Kai; Wu Wenhao; Rao Yun

doi:10.11986/j.issn.1673-873X.2025.02.15

Abstract：Objective This study aimed to explore the influencing factors of postoperative urinary retention in rectal cancer pa-tients and to construct a prediction model based on these factors,to provide early risk warnings for postoperative urinary reten-tion among these patients,optimizing clinical management and intervention strategies.Methods A retrospective study was conducted by collecting clinical data of 344 rectal cancer patients who underwent surgery at the First Affiliated Hospital of Ar-my Medical University from February 2023 to April 2024.Patients were assigned to two groups based on whether they devel-oped postoperative urinary retention:the retention group(n=37)and the non-retention group(n=307).Clinical data of the two groups were compared,and multivariate logistic regression analysis was used to identify factors affecting postoperative uri-nary retention.A prediction model was constructed based on these factors.The accuracy of the model was evaluated using Re-ceiver Operating Characteristic(ROC)curves,goodness-of-fit tests,and Decision Curve Analysis(DCA).Results Univariate analysis revealed that the retention group had a lower BMI,higher proportions of patients with a history of diabetes,a longer time of operation(≥4 hours),and a longer postoperative bed rest time compared to the non-retention group,with statistically significant differences(P＜0.05).Multivariate logistic regression showed that low BMI(OR=0.789,95％CI:0.676-0.921),diabetes(OR=4.569,95％CI:1.668-12.518),time of operation≥4 hours(OR=2.531,95％CI:1.100-5.822),and prolonged bed rest time(OR=1.232,95％CI:1.136-1.336)were independent risk factors for postoperative u-rinary retention in rectal cancer patients(P＜0.05).The Nomogram prediction model constructed from these factors showed an area under the ROC curve(AUC)of 0.876(95％CI:0.826-0.926),sensitivity of 0.884(95％CI:0.835-0.915),and specificity of 0.763(95％CI:0.659-0.901).The calibration curve and Hosmer-Lemeshow test indicated that the model had good calibration(x2=6.254,P=0.619).Conclusion Low BMI,diabetes,time of operation ≥4 hours,and prolonged bed rest time are independent risk factors for postoperative urinary retention in rectal cancer patients.The prediction model based on these factors has good predictive value and significant clinical implications for early warning of postoperative urinary reten-tion.