DOI: http://dx.doi.org/10.18203/2349-2902.isj20204679

Predictors of successful trial with-out catheter following acute urinary retention secondary to benign prostatic hypertrophy

Aditya A. Jha, Gagandeep Singh, Madhu Govindaiah, Nimit Solanki

Abstract


Background: Acute urinary retention (AUR) is one of the most psychologically distressing complications of benign prostatic hypertrophy (BPH). Attempt of trial without urinary catheter (TWOC) is given to all these patients, failing which they are subjected to surgical management. This study was conducted to analyse the possible predictors of successful trials in such patients.

Methods: Patients reporting to our centre with a first episode of spontaneous AUR secondary to BPH were enrolled. Following per-urethral catheterization residual urine volume (RUV) drained, duration of symptoms and international prostate symptom score (IPSS) were recorded. Using trans-abdominal ultrasonography (USG) prostate volume (PV), intra-vesicle prostate protrusion (IPP) and bladder wall thickness (BWT) were measured. Catheter free trial was given after a course of tamsulosin. Success was defined if patients could void >200 ml of urine within six hours of catheter removal with a maximum flow rate of >5 ml/sec and achieved a post void residual (PVR) urine volume of <150 ml.

Results: Ninety patients with 58 in successful and 32 in failed group were analysed. Significantly lesser age, IPSS, RUV, IPP and BWT was noted in successful group. Duration of LUTS and PV on USG were statistically insignificant parameters in determining a successful trial.

Conclusions: Age, IPSS, RUV, IPP and BWT may have a role in predicting successful TWOC following AUR secondary to BPH.


Keywords


Acute Urinary Retention, Benign Prostatic Hypertrophy, Trial Without Catheter

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References


Wang JY, Liu M, Zhang YG, Zeng P, Ding Q, Huang J, et al. Relationship between lower urinary tract symptoms and objective measures of benign prostatic hyperplasia: A Chinese survey. Chin Med J. 2008;121:2042-5.

Roehrborn CG. Acute urinary retention: risks and management. Rev Urol. 2005;7(4):31-41.

Chia SJ, Heng CT, Chan SP, Foo KT. Correlation of intravesical prostatic protrusion with bladder outlet obstruction. BJU Int. 2003;91:371-4.

Emberton M, Fitzpatrick JM. The Reten-World Survey of the Management of Acute Urinary Retention: Preliminary Results. BJU Int. 2008;101(3):27-32.

Tiong HY, Tibung MJB, Macalalag M, Li MK, Consigliere D. Alfuzosin 10 mg once daily increases the chances of successful trial without catheter after acute urinary retention secondary to benign prostate hyperplasia. Urol Int. 2009;83(1):44-8.

Sharis OS, Zulkifli MD, Hamzaini AH. Predicting Outcome of Trial of Voiding Without Catheter in Acute Urinary Retention with Intravesical Prostatic Protrusion. Malays J Med Sci. 2013;20(1):56-9.

Bansal A, Arora A. Predictors of successful trial without catheter following acute urinary retention in benign prostatic enlargement: A single centre, multivariate analysis. Neurourol Urodyn. 2017;36(7):1757-62.

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(1):2316-20.

Das RK, Deb PP, Basu S, Dey RK, Gupta R, Choudhary A. Factors predicting outcome of trail without catheter in patients with acute urinary retention secondary to prostate enlargement. J Clin Diagnostic Res. 2018;12(1):4-7.

Fitzpatrick JM, Desgrandchamps F , Adjali K, Guerra LG, Hong SJ, Khalid SE. Management of acute urinary retention: a worldwide survey of 6074 men with benign prostatic hyperplasia. BMJ Int. 2011;109:88-95.

Mahadik P, Vaddi SP, Godala CM, Reddy, VK, Sambar VK. Factors Affecting Trial Without Catheter for First Spontaneous Acute Urinary Retention. Int Neurourol J. 2013;17(3):121-6.

Bhomi KK, Bhattachan CL. Factors predicting the success of a trial without catheter in acute urinary retention secondary to benign prostatic hyperplasia. Nepal Med Coll J. 2011;13:178-81.

Li YK, Leung CS, Hui TL, Chiu LH. Acute urinary retention: how useful is an ambulatory care protocol? Hong Kong J Emerg Med. 2009;16:134-40.

Zeif H, Wallace DM, Subramonian K. Predictors of successful trial without catheter in acute urinary retention. Br J Med Surg Urol. 2010;3:5-10.

Lim KB, Wong MY, Foo KT. The outcome of trial off catheter after acute retention of urine. Ann Acad Med Singapore. 1999;28:516-8.

Bae JH, Kang SH, Cheon J, Ko YH, Cho DY, Lee JG. Determinant factors affecting successful voiding trial without catheter (TWOC) after single intermittent catheterisation for the acute urinary retention patients due to benign prostatic obstruction. BJU Int. 2006;97:727-33.

Maha P, Vaddi S, Godala CM, Reddy VVK. Factors Affecting Trial Without Catheter for First Spontaneous Acute Urinary Retention. Int Neurourol J. 2013;17(3):121-6.

Kurniasari D, Budiono, Tarmono, Hardjowijoto, Soetojo. Predicts the Successfulness of a Trial Voiding Without Catheter (TWOC) Through Urine Retention Volume, Detrusor Wall Thickness (DWT) and Intravesical Protrusion of Prostate (IPP) on Acute Urinary Retention (AUR) Patients Due to Benign Prostatic Hyperplasia (BPH). Ind J Public Health Res Develop. 2019;10(4):1308-14.