Acute urinary retention: what is the impact on patients’ quality of life?

Thomas, Kay; Oades, Grenville; Taylor-Hay, C.; Kirby, Roger

doi:10.1111/j.1464-410x.2004.05254.x

Cited by 59 publications

(30 citation statements)

References 26 publications

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“…Also 67% of patients who experienced AUR eventually underwent BPH related surgery [23]. AUR had an impact on patients' healthrelated QoL with high pain scores and economic burden reported [24]. Thus, patients with AUR tend to get early surgical treatment for their voiding problems.…”

Section: Discussionmentioning

confidence: 99%

Predictors of urgency improvement after Holmium laser enucleation of the prostate in men with benign prostatic hyperplasia

Hur

Kim

et al. 2016

Investig Clin Urol

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PurposeTo investigate the change in urinary urgency and predictors of urgency improvement after holmium laser enucleation of the prostate (HoLEP) in men with benign prostatic hyperplasia (BPH).Materials and MethodsWe retrospectively analyzed the medical records of patients who were treated with HoLEP for BPH and had preoperative urgency measuring ≥3 on a 5-point urinary sensation scale. Those with prostate cancer diagnosed prior to or after HoLEP, a history of other prostatic and/or urethral surgery, moderate to severe postoperative complications, and neurogenic causes were excluded. Patients who had improved urgency with antimuscarinic medication after HoLEP were excluded. We divided the patients into 2 groups based on urgency symptoms 3 months after HoLEP: improved and unimproved urgency. Improved urgency was defined as a reduction of 2 or more points on the 5-point urinary sensation scale. Preoperative clinical and urodynamic factors as well as perioperative factors were compared between groups.ResultsIn total, 139 patients were included in this study. Voiding parameters in all patients improved significantly after HoLEP. Seventy-one patients (51.1%) had improved urgency, while 68 (48.9%) did not show any improvement. A history of acute urinary retention (AUR) and postvoid residual were associated with postoperative urgency improvement in univariate analysis. In multivariate analysis, a history of AUR was an independent factor affecting urgency improvement.ConclusionsA preoperative history of AUR could influence the change in urgency after HoLEP surgery in patients with BPH.

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Section: Discussionmentioning

confidence: 99%

Predictors of urgency improvement after Holmium laser enucleation of the prostate in men with benign prostatic hyperplasia

Hur

Kim

et al. 2016

Investig Clin Urol

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“…Acute urinary retention (AUR) is sudden onset and painful due to stretching of the bladder caused by overfilling; the pain can be so severe that it is likened to that of renal colic or childbirth. [34] Typically, patients present as a urological emergency with bladder volumes between 500 mls and 1 L. In chronic urinary retention (CUR) patients tend to suffer from incomplete voiding with significant post-void residual urine volumes (PVR) ranging between 300 ml and 1000 mls and present with acute on chronic retention. CUR is usually painless due to its slow onset and presents with higher retained volumes, between 450 mls and 4.5 L or more.…”

Section: Introductionmentioning

confidence: 99%

Management of the complications of BPH/BOO

Speakman

Cheng

2014

Indian J Urol

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Most men will develop histological BPH if they live long enough. Approximately, half will develop benign prostatic enlargement (BPE) and about half of these will get BOO with high bladder pressures and low flow, this in turn leads to detrusor wall hypertrophy. Many of these men will only have lower urinary tract symptoms (LUTS) but a significant number will also suffer the other complications of BPH. These include urinary retention (acute and chronic), haematuria, urinary tract infection, bladder stones, bladder wall damage, renal dysfunction, incontinence and erectile dysfunction. Recognition of the complications of BPH/BOO early allows more effective management of these complications. This is particularly important for the more serious urinary infections and also for high-pressure chronic retention (HPCR). Complications of LUTS/BPH are very rare in clinical trials because of their strict inclusion and exclusion criteria but are more common in real life practice.

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“…It is a distressing condition [2] that represents a major public health issue. Within the last decade, AUR has become the most common indication for TURP, increasing from 22.9% in 1988 to 42.9% in 1998 [3].…”

Section: Introductionmentioning

confidence: 99%

Management of acute urinary retention: a worldwide survey of 6074 men with benign prostatic hyperplasia

et al. 2011

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OBJECTIVESTo evaluate the management of acute urinary retention (AUR) associated with benign prostatic hyperplasia (BPH) in real-life practice.To identify predictors of successful trial without catheter (TWOC).MATERIALS AND METHODSIn all, 6074 men catheterized for painful AUR were enrolled in a prospective, cross-sectional survey conducted in public and private urology practices in France, Asia, Latin America, Algeria and the Middle East.Patient clinical characteristics, type of AUR and its management (type of catheterization, hospitalization, TWOC, use of α1-blockers, immediate or elective surgery) and adverse events observed during the catheterization period were recorded.Predictors of TWOC success were also analysed by multivariate regression analysis with stepwise procedure.RESULTSOf the 6074 men, 4289 (71%) had a spontaneous AUR and 1785 (29%) had a precipitated AUR, mainly as the result of loco-regional/general anaesthesia (28.5%) and excessive alcohol intake (18.2%).Presence of BPH was revealed by AUR in 44% of men. Hospitalization for AUR varied between countries, ranging from 1.7% in Algeria to 100% in France. A urethral catheter was inserted in most cases (89.8%) usually followed by a TWOC (78.0%) after a median of 5 days. Overall TWOC success rate was 61%.Most men (86%) received an α1-blocker (mainly alfuzosin) before catheter removal with consistently higher TWOC success rates, regardless of age and type of AUR. Multivariate regression analysis confirmed that α1-blocker before TWOC doubled the chances of success (odds ratio 1.92, 95% CI 1.52–2.42, P < 0.001).Age ≥70 years, prostate size ≥50 g, severe lower urinary tract symptoms, drained volume at catheterization ≥1000 mL and spontaneous AUR favoured TWOC failure. Catheterization >3 days did not influence TWOC success but was associated with increased morbidity and prolonged hospitalization for adverse events.In the case of TWOC failure, 49% of men were recatheterized and had BPH surgery and 43.5% tried another TWOC with a success rate of 29.5%. Elective surgery was preferred to immediate surgery.CONCLUSIONSTWOC has become a standard practice worldwide for men with BPH and AUR.In most cases, an α1-blocker is prescribed before TWOC and significantly increases the chance of success.Prolonged catheterization is associated with an increased morbidity.

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Acute urinary retention: what is the impact on patients’ quality of life?

Cited by 59 publications

References 26 publications

Predictors of urgency improvement after Holmium laser enucleation of the prostate in men with benign prostatic hyperplasia

Predictors of urgency improvement after Holmium laser enucleation of the prostate in men with benign prostatic hyperplasia

Management of the complications of BPH/BOO

Management of acute urinary retention: a worldwide survey of 6074 men with benign prostatic hyperplasia

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