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

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

doi:10.18203/2349-2902.isj20204679

Cited by 2 publications

(1 citation statement)

References 11 publications

(15 reference statements)

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“…Regarding another medication frequently used in BPH, 5-ARI, several studies have demonstrated that in addition to the effect on prostatic volumetry, this therapeutic class also proves its effectiveness by reducing the microvascular density of the prostatic parenchyma, thus resulting in a decrease in bleeding intraoperatively during transurethral prostate resection as well as postoperatively, significantly reducing the probability of macroscopic haematuria [ 17 ]. No research has been conducted on the utility of 5-ARI in TWOC.…”

Section: Discussionmentioning

confidence: 99%

Elements for Trial Without Catheter (TWOC) Success in Benign Prostatic Hyperplasia Patients: Lessons We Have Learned

Ivanuta,

Puia,

Pricop

2023

Cureus

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Background: Benign prostatic hyperplasia (BPH) is a progressive disease that causes low urinary tract symptoms (LUTS). As prostatic volume grows, the prostatic urethra may become completely obstructed, resulting in full urine retention and acute hypogastric pain. Our research aimed to identify the optimal trial without catheter (TWOC) therapeutic approach and identify those factors that are associated with the recurrence of complete urinary retention (CUR). Methodology: The study enrolled with complete urinary retention and BPH were included in the study, after the insertion of a Foley catheter. The patients received tamsulosin 0.4 mg/day as an alpha-blocker treatment. In our investigation, patients who encountered complete urinary retention were randomly categorized into four groups based on the duration of urinary catheterization as determined by the attending urologist. Results: Maintaining the urethrovesical catheter for three to seven days was related to the highest success of spontaneous urination, which was statistically significant compared to other study groups. (p=0.0007). Age over 70 years, no alpha-blocker before the urinary retention episode, and prostatic volume exceeding 50 ml were all associated with decreased TWOC efficacy. We found the highest rates of spontaneous urination were after three to seven days of urinary catheterization. Conclusion: BPH and complete urine retention can be managed by TWOC in many cases. Several factors affect the test's efficacy. Prolonged urinary catheter maintenance over seven days, prostatic volume over 50 ml, and age over 70 years are poor prognostic indicators.

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Section: Discussionmentioning

confidence: 99%

Elements for Trial Without Catheter (TWOC) Success in Benign Prostatic Hyperplasia Patients: Lessons We Have Learned

Ivanuta,

Puia,

Pricop

2023

Cureus

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Immediate or delayed trial without catheter in acute urinary retention in males: A systematic review

Christensen,

Skow,

Flottorp

et al. 2024

BJUI Compass

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ObjectiveTo compare the success of establishing spontaneous micturition following immediate trial without catheter (TWOC) to delayed TWOC in males catheterized for acute urinary retention.Materials and methodsIn this systematic review, we included studies reporting success rates of immediate TWOC or delayed TWOC (≤30 days) among males ≥18 years of age catheterized for acute urinary retention. We excluded studies on suprapubic catheterization, postoperative/perioperative catheterization and urinary retention related to trauma. We searched the following databases: MEDLINE, Embase, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Open Grey and Clinicaltrials.gov. The search was concluded on 30 November 2022. There were no restrictions on language or publication date. Risk of bias was assessed using the ROB 2.0 and ROBINS‐I tools. We did random‐effects restricted maximum likelihood model meta‐analyses. Certainty of evidence was assessed using GRADE.ResultsWe included 61 studies. In two randomized controlled trials (RCTs), both with some concerns for risk of bias, including in total 174 participants, the relative success rate was 1.22 (95% CI 0.84–1.76) favouring delayed TWOC. In two comparative cohort studies, both with serious risk of bias, including 642 participants, the relative success rate was 1.18 (0.94–1.47) favouring delayed TWOC. One study was excluded from this meta‐analysis because of critically low quality. Four studies reporting success rates for cohorts with immediate TWOC, all with serious risk of bias, including 409 participants, had an overall success rate of 47% (29–66). Fifty‐two studies reporting success rates for cohorts with delayed TWOC, all with serious risk of bias, including 12 489 participants, had an overall success rate of 53% (49–56). The certainty of the evidence was considered low for the RCTs and very low for the rest.ConclusionThere was a limited number of appropriately designed studies addressing the research question directly. The evidence favours neither approach.

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

Cited by 2 publications

References 11 publications

Elements for Trial Without Catheter (TWOC) Success in Benign Prostatic Hyperplasia Patients: Lessons We Have Learned

Elements for Trial Without Catheter (TWOC) Success in Benign Prostatic Hyperplasia Patients: Lessons We Have Learned

Immediate or delayed trial without catheter in acute urinary retention in males: A systematic review

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