PDF
ePub
Citation
Print
Abstract
Purpose
Acute urinary retention (AUR) is a serious outcome of benign prostatic hyperplasia (BPH). Although Foley indwelling catheterization is a standard treatment for the conservative management of AUR, we studied the success rate of in-and-out catheterization and the factors that favor a positive outcome of a trial treatment without using a catheter (TWOC).
Materials and Methods
We retrospectively reviewed the medical record of all 127 patients who admitted as emergency cases with primary AUR caused by BPH (from January 2002 to August 2005), and these patients underwent in-and-out catheterization or Foley indwelling catheterization and then they underwent TWOC 1 week later after the first treatment. The patients were divided into four groups: the success group (group I) or failure group (group II) that underwent in-and-out catheterization and the success group (group III) or failure group (group IV) that underwent TWOC. The factors that might influence the outcomes were assessed using logistic regression analysis and Student's t-test.
Results
Of the 62 patients who underwent in-and-out catheterization, 30 had no further episodes of AUR during 1-year follow up (group I) and the other patients had repeated episodes (group II). For the clinical parameters, only the retained urine volume was significantly difference between the two groups. The multivariate analysis revealed that the statistically significant influencing factor was urinary retention volume (p<0.01).
Figures and Tables
Table 1
Comparison of the clinical parameters between in-and-out catheterization and an indwelling Foley catheter
Table 2
Clinical parameters for the trial without a catheter (TWOC) in the patient who underwent in-and-out catheterization
References
1. Kurita Y, Masuda H, Terada H, Suzuki K, Fujita K. Transition zone index as a risk factor for acute urinary retention in benign prostatic hyperplasia. Urology. 1998. 51:595–600.
2. Schulman CC. Long-term aspects of medical treatment of BPH. Eur Urol. 2001. 40:Suppl 3. 8–12.
3. George NJ. O'Reilly PH, editor. Obstructive and functional abnormalities I. Obstructive uropathy. 1985. 1st ed. New York: Springer-Verlag;236–275.
4. Caine M. Hinman F, editor. Dynamic of acute retention. Benign prostatic hypertrophy. 1983. 1st ed. New York: Springer-Verlag;497–501.
5. Breum L, Klarskov P, Munck LK, Nielsen TH, Nordestgaard AG. Significance of acute urinary retention due to infravesical obstruction. Scand J Urol Nephrol. 1982. 16:21–24.
6. Murray K, Massey A, Feneley RC. Acute urinary retention-a urodynamic assessment. Br J Urol. 1984. 56:468–473.
7. Emberton M, Anson K. Acute urinary retention in men: an age old problem. BMJ. 1999. 318:921–925.
8. Desgrandchamps F, De La Taille A, Doublet JD. The management of acute urinary retention in France: a cross-sectional survey in 2618 men with benign prostatic hyperplasia. BJU Int. 2006. 97:727–733.
9. Annemans L, Cleemput I, Lamotte M, McNeill A, Hargreave T. The economic impact of using alfuzosin 10mg once daily in the management of acute urinary retention in the UK: a 6-month analysis. BJU Int. 2005. 96:566–571.
10. Taube M, Gajraj H. Trial without catheter following acute retention of urine. Br J Urol. 1989. 63:180–182.
11. McNeill SA, Donat R, Pillai MK, Hargreave TB, Daruwalla P, Goodman CM, et al. Prospective multicentre randomised placebo double blind study of the effect of alfuzosin on the outcome of trial removal of catheter following acute urinary retention. J Urol. 1998. 159:Suppl. 256.
12. Pickard R, Emberton M, Neal DE. National Prostatectomy Audit Steering Group. The management of men with acute urinary retention. Br J Urol. 1998. 81:712–720.
13. Djavan B, Madersbacher S, Klingler C, Marberger M. Urodynamic assessment of patients with acute urinary retention: is treatment failure after prostatectomy predictable? J Urol. 1997. 158:1829–1833.
14. McNeill SA, Daruwala PD, Mitchell ID, Shearer MG, Hargreave TB. Sustained-release alfuzosin and trial without catheter after acute urinary retention: a prospective, placebo-controlled trial. BJU Int. 1999. 84:622–627.
15. McNeill A, Naadimuthu A, Hargreave T. Alfuzosin 10mg once daily in the management of acute urinary retention-preliminary results of the ALFAUR study. Eur Urol. 2003. 42:75.
16. Hargreave TB, Hindmarsh JR, Elton R, Chisholm GD, Gould JC. Short-term prophylaxis with cefotaxime for prostatic surgery. Br Med J (Clin Res Ed). 1982. 284:1008–1010.
17. Hastie KJ, Dickinson AJ, Ahmad R, Moisey CU. Acute retention of urine: is trial without catheter justified? J R Coll Surg Edinb. 1990. 35:225–227.
18. Klarskov P, Andersen JT, Asmussen CF, Brenoe J, Jensen SK, Jensen IL, et al. Symptoms and signs predictive of the voiding pattern after acute urinary retention in men. Scand J Urol Nephrol. 1987. 21:23–28.
19. McNeill SA, Hargreave TB. Members of the Alfaur Study Group. Alfuzosin once daily facilitates return to voiding in patients in acute urinary retention. J Urol. 2004. 171:2316–2320.
20. Park SH, Kwon TG, Kim DY, Park CH, Seo JH, Lee JH, et al. The factors that influence the clinical outcomes after trial without catheter for acute urinary retention due to benign prostatic hyperplasia: a multicenter trial. Korean J Urol. 2006. 47:1074–1078.
21. Djavan B, Shariat S, Omar M, Roehrborn CG, Marberger M. Does prolonged catheter drainage improve the chance of recovering voluntary voiding after acute urinary retention (AUR). Eur Urol. 1998. 33:Suppl. 110. abstract 437.
22. Kumar V, Marr C, Bhuvangiri A, Irwin P. A prospective study of conservatively managed acute urinary retention: prostate size matters. BJU Int. 2000. 86:816–819.
23. McConnell JD, Bruskewitz R, Walsh P, Andriole G, Lieber M, Holtgrewe HL, et al. Finasteride Long-Term Efficacy and Safety Study Group. The effect of finasteride on the risk of acute urinary retention and the need for surgical treatment among men with benign prostatic hyperplasia. N Engl J Med. 1998. 338:557–563.
XML Download