Trial without Catheter following Acute Retention of Urine

Taube, Magdalena; Gajraj, H

doi:10.1111/j.1464-410x.1989.tb05160.x

Cited by 85 publications

(63 citation statements)

References 9 publications

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“…Over a decade later, in another retrospective study, Breum et al [4] reported an incidence of surgery of 84% at 5 years within their cohort of 70 patients. Prospective studies in this area are sparse and often provide a short follow-up of few patients [5]. Klarskov et al [6] reported the longest follow-up to date in a prospective study of 1 year with a surgical intervention rate of 85%; in that study of 228 men with AUR they reported that factors predictive of preserved voiding ability after a successful TWOC were a retained volume of < 500 mL, a maximum flow rate of > 5 mL/s, and the presence of an event thought to provoke AUR.…”

Section: Discussionmentioning

confidence: 99%

Prostate size influences the outcome after presenting with acute urinary retention

2004

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OBJECTIVETo evaluate the long-term outcome in an open follow-up of a cohort of patients who had had a successful trial without catheter (TWOC) after an episode of acute urinary retention (AUR), as it is now widely accepted that giving an a -blocker, e.g. alfuzosin, increases the success rate of TWOC. PATIENTS AND METHODSIn this prospective trial, 81 patients with a first episode of AUR related to benign prostatic obstruction received either sustained-release alfuzosin (40) 5 mg twice daily or placebo (41) for 48 h. The catheter was removed after 24 h of treatment and the patient's ability to void assessed. Those who voided successfully entered an open follow-up, the defined endpoints of which were the date of recurrent AUR, date of bladder outlet surgery, date of last follow-up or death, and factors that influenced the long-term outcome after a successful TWOC were examined. RESULTSOf the 34 patients who had a successful TWOC (22 on alfuzosin, 12 placebo, P = 0.03), 21 continued on an a -blocker at the discretion of their urologist. In all, 26 had a further episode of AUR or surgery during the 6-year follow-up. The mean (median, range) time to the second episode of AUR in the 20 (59%) patients affected was 1.4 (0.6, 0-5.95) years. Nineteen (56%) men had bladder outlet surgery, 13 after a second episode of AUR. The mean time to operation after the first AUR was 1.85 (1.1, 0.04-5.4) years. The remaining eight (24%) patients remained free of further AUR and surgery. The size of the prostate assessed on a digital rectal examination by the admitting urologist was the only factor with a significant effect on the long-term outcome. A postvoid residual of > 50 mL was associated with a greater likelihood of recurrent AUR or surgery, but this was not statistically significant. CONCLUSIONSThis study provides further evidence of the importance of prostate size as a prognostic factor in determining the outcome in patients with prostatic obstruction. Whilst most men presenting with AUR will eventually have prostatic surgery, a significant minority will not. An assessment of risk factors such as prostate size may identify those who require urgent intervention after a successful TWOC. The role of continued medical therapy with ablockers and/or 5 a -reductase inhibitors after a successful TWOC merits further investigation.

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Section: Discussionmentioning

confidence: 99%

Prostate size influences the outcome after presenting with acute urinary retention

2004

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“…In a study of 60 patients with AUR in whom the catheter was removed no later than 48 h after catheterization, 17 patients (28%) voided successfully [56]. When these 17 patients were followed up for 6 months, six had required prostatectomy for severe LUTS while 11 had no or only minor symptoms.…”

Section: A Trial Without Cathetermentioning

confidence: 99%

Acute urinary retention

2000

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“…While some have found no difference in success rates at 24 and 48 h, 32 others have suggested a benefit to waiting longer, particularly in men with large residual volumes 41 l. 33 It has recently been suggested that prostate size 427.5 g, residual volume 41 l and age 475 y may reduce the chance of successfully voiding after a TWOC. 34 It has also been suggested that the use of an alpha blocker may improve the success rate of a TWOC.…”

Section: Treatment Catheterisationmentioning

confidence: 99%

Acute Urinary Retention: a review of the aetiology and management

Thomas

Chow

Kirby

2004

Prostate Cancer Prostatic Dis

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Acute retention of urine (AUR) is a common urological emergency characterised by a sudden inability to pass urine associated with lower abdominal pain. In recent years, the natural history and incidence of AUR has become better understood, however, further research into methods to prevent it and evaluation of the impact an episode of AUR has on the patient is required. This review provides an overview of the current management of AUR in men and the impact of the condition on patients' quality of life.

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Trial without Catheter following Acute Retention of Urine

Cited by 85 publications

References 9 publications

Prostate size influences the outcome after presenting with acute urinary retention

Prostate size influences the outcome after presenting with acute urinary retention

Acute urinary retention

Acute Urinary Retention: a review of the aetiology and management

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