Admission of patients with acute urinary retention leads to a definitive management decision

Ryan, P. C.; Ryan, Éanna J; Keenan, Robert; Haroon, Usman M; Broe, M.; Forde, James; Galvin, David; Lennon, G. M.; Murphy, Michael; Quinlan, David M.; Mulvin, D.

doi:10.1007/s11845-019-02164-8

Cited by 3 publications

(3 citation statements)

References 29 publications

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“…This local study also found that a delayed TURP resulted in an increased risk of a UTI perioperatively but a decreased length of stay. [6][7][8] From our findings of a median length of stay of two days for all cohorts, both cycles suggest that the delayed timing of an elective TURP does not influence length of stay. None of our patients underwent an immediate TURP.…”

Section: Timing Of Turpmentioning

confidence: 99%

Prioritisation of catheterised patients for elective bladder outflow obstruction surgery in the current coronavirus disease 2019 era to reduce catheter-associated morbidity

Lam

Wong

Nitkunan

2020

Journal of Clinical Urology

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Objectives: This study aimed to audit the waiting times for a transurethral resection of prostate (TURP) at our institution, and to evaluate the extent of catheter-associated morbidity in this population. Methods: This was a retrospective closed-loop audit, with cycle one between 1 January 2018 and 31 December 2018 and cycle two between 1 October 2019 and 29 February 2020. Data collected included patient demographics, catheter status, catheter-associated presentations to accident and emergency (A&E), admissions and waiting times for TURP. The waiting-list form now has a catheter box, and a goal of 30 days from waitlisting to operation was set for those catheterised. Results: In cycle 1, 36% of the 181 patients were catheterised, and waited a median of 119 days (interquartile range (IQR) 59–163 days) for their TURP, while those not catheterised waited a median of 118 days (IQR 57.75–188.25 days). Catheterised patients presented to A&E 93 times, resulting in 13 admissions, compared to two presentations and zero admissions for those not catheterised. The median time from catheter insertion to first A&E attendance was 20 days (IQR 2–101 days). In cycle 2, 33% of the 55 patients were catheterised, with the median waiting-list time falling to 32 days (IQR 22–46 days) in those catheterised and 33 days (IQR 20–49 days) in those not catheterised. All 11 A&E attendances were from catheterised patients, with no admissions. The median time from insertion to first A&E attendance was nine days (IQR 4–40 days). Eighty-eight per cent of the waiting-list forms had appropriately ticked the catheter box. Conclusion: Our study shows that catheterised patients awaiting a TURP are more likely to have complications necessitating A&E attendance. Prioritisation of these patients on the waiting list for bladder outflow obstruction surgery may help to reduce catheter-associated morbidity. Level of evidence: Level 2c.

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Section: Timing Of Turpmentioning

confidence: 99%

Prioritisation of catheterised patients for elective bladder outflow obstruction surgery in the current coronavirus disease 2019 era to reduce catheter-associated morbidity

Lam

Wong

Nitkunan

2020

Journal of Clinical Urology

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“…сти какого-либо хирургического вмешательства; 1 (6,25 %) человеку проведена радикальная простатэктомия по поводу доказанной биопсией аденокарциномы простаты [35].…”

Section: Clinical Medicineunclassified

Choosing the method of urine derivation in patients with acute urinary retention: current status of the problem

Alexander

Анатольевич²,

Виноградов

et al. 2020

Aspirantskiy Vestnik Povolzhiya

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Acute urinary retention (AUR) is an acute inability to empty the bladder, despite its overflow with urine and the urge to urinate. According to the literature data, about 10% of men over 70 years old and about 30% of men over 80 years old suffer this disorder. At the same time, almost 90% of men over 45 years have symptoms of the lower urinary tract disorders and can be included into the risk group for developing of AUR in future. The risk of developing of AUR in middle-aged men is approximately 6.8 cases per 1000 men and increases to 34.7 cases in men over 70 years. Urinary retention remains a common cause of emergency hospitalization of patients to urological departments, as well as the most common complication of benign prostatic hyperplasia (BPH). According to epidemiological studies, 10% of men aged 60-70 years suffer acute urinary retention within 5 years, and their proportion increases up to 30% within 10 years of observation. The main risk factors for the development of AUR in men are old age, the severity of lower urinary tract symptoms (LUTS), and prostate volume.

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“…However BPH accounts for more than 75% of cases in men over 70 years. The age related morbidity over one year ranges from 4.1% in 45-54 years to 32.8% from those above 85 years of age 2 . A large cohort based studies, on California men, found increasing incidence among Asians, and Hispanics 3 .…”

Section: Introductionmentioning

confidence: 99%

Role of Combined Ketoconazole and Tamsulosin in Successful Trial of Voiding Without Catheter (Twoc) in Patients With Acute Urinary Retention Due to Benign Prostatic Obstruction

Asim

Ahmed

Ali

et al. 2020

PAFMJ

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Objective: To compare the frequency of patients with successful Trial of voiding without catheter (TWOC) after acute urinary retention secondary to benign prostatic hyperplasia in patients taking ketoconazole and tamsulosin vs tamsulosin alone. Study Design: A randomized controlled trial. Place and Duration: The current study was conducted at Urology Ward, Liaquat National Hospital, Pakistan for a period of six months. Methodology: A total of 162 patients presenting with acute urinary retention were divided into two groups. Group A received tamsulosin 0.4mg OD and ketoconazole 200mg while Group B received tamsulosin and placebo. Trial of voiding without a catheter was induced after one week of medication. SPSS version 20 was used for data compilation and analysis. Results: In Group-A, 85.2% of patients were able to void as compared to group B, where only 74.1% of patients were able to void (p<0.05). Successful trial of voiding without catheter was observed in 79.0% and 60.5% in patients of Group-A and Group-B respectively. The association of successful TWOC with the two study groups was found significant (p=0.010). Conclusion: TWOC in men catheterized for AUR due to BPH was significantly more successful if treated in a combination of ketoconazole and tamsulosin as compared to tamsulosin only.

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Admission of patients with acute urinary retention leads to a definitive management decision

Cited by 3 publications

References 29 publications

Prioritisation of catheterised patients for elective bladder outflow obstruction surgery in the current coronavirus disease 2019 era to reduce catheter-associated morbidity

Prioritisation of catheterised patients for elective bladder outflow obstruction surgery in the current coronavirus disease 2019 era to reduce catheter-associated morbidity

Choosing the method of urine derivation in patients with acute urinary retention: current status of the problem

Role of Combined Ketoconazole and Tamsulosin in Successful Trial of Voiding Without Catheter (Twoc) in Patients With Acute Urinary Retention Due to Benign Prostatic Obstruction

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