Objectives of this study were to evaluate men who underwent prostatic surgery for bladder outlet obstruction (BOO) in the Urology Unit, Provincial General Hospital (PGH) Badulla with regard to their demographic data, clinical presentation, correlation of digital rectal examination (DRE) findings with histology and various surgical interventions and their complications. DOI: 10.4038/slju.v9i1.1958 Sri Lanka Journal of Urology, 2008, 9, 13-19

Introduction We investigated patients with acute urinary tract obstruction in a DGH to ascertain which factors predispose to CKD and mortality. Method Over five months there were 37 nephrostomy/stent cases, 18 female, 3 mortalities. Median age was 55.5 (18-93). Retrospective data was used in a multiple regression analysis. Input variables included the intervention indication, admission Creatinine, Charlson Co-morbidity Index, and intervention delay. Output variables were length of hospital stay, renal function and 90-day mortality. Results Positive urine cultures (p = 0.035) and co-morbidity (p = 0.018) were associated with CKD. Nephrostomy patients (p = 0.031) were associated with AKI post-procedure. Delay in disobstruction (p < 0.01) and delay-length (p = 0.026) were significantly associated with longer hospital stays. AKI severity on admission (p = 0.047) and intervention delay (p = 0.045) increased risk of 90-day mortality, with positive blood cultures (p = 0.071) trending towards significance. Malignant obstruction neared a significant association with CKD (p = 0.08) and 90-day mortality (p = 0.075). Conclusions The severity of presentation and delay in intervention all contribute to poorer outcomes and a longer admission. Co-morbid patients with malignant obstruction had a higher risk of 90-day mortality. Therefore, in those with poor baseline, are we intervening inappropriately?