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Introduction: We performed a prospective, randomized, double-blinded controlled trial to investigate whether use of DOVERTM Urine Collection Systems with top vent (Tyco Healthcare Group L.P. d/b/a Couidien, Marshfield, MA, USA) top-vented urinary catheters cause fewer epithelial and vascular changes in the bladder mucosa than conventional non-vented catheters. Materials and Methods: Women undergoing a mid-urethral sling were randomized to either placement of a non-vented or top-vented catheter. Primary outcome was change in appearance of the bladder mucosa as graded on a 4-point scale (0–3) after a single drainage event. Secondary outcome was change in red and white blood cell counts per high power field between urinalyses collected intraoperatively and after overnight bladder drainage. A paired T-test with Wilcoxon rank sum was used to compare the grade of mucosal change and the change in cell count. Results: Forty-one women were randomized. The mean change in appearance of the bladder mucosa was significantly greater in the conventional drainage catheter group (2.0 ± 0.23 vs. 0.4 ± 0.11, p < 0.0001). There was no significant difference in the mean cell count intervals on urinalyses between the two groups (1.2 ± 0.34 vs. 0.8 ± 0.34, p = 0.08). Conclusions: By avoiding suction on the bladder mucosa, top-vented urinary catheters cause fewer epithelial and vascular changes in the bladder mucosa compared to conventional catheters.

then 2 mg twice daily). Forty-five patients developed acute urinary retention at a median of 12 days after implantation. Univariate and multivariate analyses were used to evaluate the potential risk factors for urinary retention. RESULTSAcute urinary retention developed in 11.1% of the patients and the risk was predicted by increasing prostate volume at the time of diagnosis. This risk was higher (18.8%) for men receiving no dexamethasone and lower (8.2%) for those who did. In the multivariate analysis the volume at diagnosis and the use of dexamethasone remained significant. The use of steroids counterbalanced the effect of increasing prostate volume on the incidence of retention. The risk of retention was higher in those men receiving androgen deprivation to shrink their prostates than in those whose prostates were of suitable size for implantation at the time of diagnosis. CONCLUSIONReducing prostate volume by androgen deprivation before brachytherapy may be less important in preventing brachytherapyrelated urinary retention than the use of corticosteroids to reduce oedema afterward.

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