Management outcome of acute urinary retention: model of prediction.

Hdl Handle:
http://hdl.handle.net/10147/206372
Title:
Management outcome of acute urinary retention: model of prediction.
Authors:
Daly, Padraig; Connolly, Stephen; Rogers, Eamonn; Sweeney, Paul
Affiliation:
Department of Urology, Mercy University Hospital, University College Cork, Cork, , Ireland.
Citation:
Urol Int. 2009;83(1):39-43. Epub 2009 Jul 27.
Journal:
Urologia internationalis
Issue Date:
31-Jan-2012
URI:
http://hdl.handle.net/10147/206372
DOI:
10.1159/000224866
PubMed ID:
19641357
Abstract:
OBJECTIVES: To assess for predictors of outcome in patients presenting with acute urinary retention (AUR). METHODS: A study was performed in our unit to evaluate trial without catheter (TWOC) and successive management. We assessed for predictors of surgical or medical management, which included: age, volume drained at time of catheterisation, cause of retention, serum creatinine, success of trial of voiding, co-morbidities, prostate-specific antigen (PSA) and prostate size on digital rectal examination (DRE). RESULTS: 72 men were entered into the study over an 18-month period: 27 had a successful first TWOC, 20 patients had a second TWOC, and 6 were successful. In total, 31 of the 33 patients with a successful TWOC remained on alpha-blockers without a further episode of AUR within a minimum of 6 months' follow-up. Patients failing TWOC were managed by transurethral resection of the prostate (n = 22), long-term catheterisation (n = 15) or prostatic stents (n = 3), and 1 patient died prior to intervention. Three predictors were significant on multivariate analysis: PSA (>2.9 ng/ml), prostate size on DRE (large) and volume drained at time of catheterisation (>or=1,000 ml). CONCLUSION: Patients with elevated PSA (>2.9 ng/ml), a large prostate size on DRE and a volume drained at time of catheterisation >1,000 ml are best managed by surgical intervention, while those with volumes drained at time of catheterisation of <1,000 ml, a PSA <or=2.9 ng/ml, and moderate to small prostate on DRE may be managed medically.
Language:
eng
MeSH:
Acute Disease; Adrenergic alpha-Antagonists/therapeutic use; Aged; Aged, 80 and over; Emergencies; Humans; Male; Middle Aged; Prostatic Hyperplasia/complications/surgery; Transurethral Resection of Prostate; Urinary Catheterization; Urinary Retention/etiology/*therapy; Urination
ISSN:
1423-0399 (Electronic); 0042-1138 (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorDaly, Padraigen_GB
dc.contributor.authorConnolly, Stephenen_GB
dc.contributor.authorRogers, Eamonnen_GB
dc.contributor.authorSweeney, Paulen_GB
dc.date.accessioned2012-01-31T16:39:04Z-
dc.date.available2012-01-31T16:39:04Z-
dc.date.issued2012-01-31T16:39:04Z-
dc.identifier.citationUrol Int. 2009;83(1):39-43. Epub 2009 Jul 27.en_GB
dc.identifier.issn1423-0399 (Electronic)en_GB
dc.identifier.issn0042-1138 (Linking)en_GB
dc.identifier.pmid19641357en_GB
dc.identifier.doi10.1159/000224866en_GB
dc.identifier.urihttp://hdl.handle.net/10147/206372-
dc.description.abstractOBJECTIVES: To assess for predictors of outcome in patients presenting with acute urinary retention (AUR). METHODS: A study was performed in our unit to evaluate trial without catheter (TWOC) and successive management. We assessed for predictors of surgical or medical management, which included: age, volume drained at time of catheterisation, cause of retention, serum creatinine, success of trial of voiding, co-morbidities, prostate-specific antigen (PSA) and prostate size on digital rectal examination (DRE). RESULTS: 72 men were entered into the study over an 18-month period: 27 had a successful first TWOC, 20 patients had a second TWOC, and 6 were successful. In total, 31 of the 33 patients with a successful TWOC remained on alpha-blockers without a further episode of AUR within a minimum of 6 months' follow-up. Patients failing TWOC were managed by transurethral resection of the prostate (n = 22), long-term catheterisation (n = 15) or prostatic stents (n = 3), and 1 patient died prior to intervention. Three predictors were significant on multivariate analysis: PSA (>2.9 ng/ml), prostate size on DRE (large) and volume drained at time of catheterisation (>or=1,000 ml). CONCLUSION: Patients with elevated PSA (>2.9 ng/ml), a large prostate size on DRE and a volume drained at time of catheterisation >1,000 ml are best managed by surgical intervention, while those with volumes drained at time of catheterisation of <1,000 ml, a PSA <or=2.9 ng/ml, and moderate to small prostate on DRE may be managed medically.en_GB
dc.language.isoengen_GB
dc.subject.meshAcute Diseaseen_GB
dc.subject.meshAdrenergic alpha-Antagonists/therapeutic useen_GB
dc.subject.meshAgeden_GB
dc.subject.meshAged, 80 and overen_GB
dc.subject.meshEmergenciesen_GB
dc.subject.meshHumansen_GB
dc.subject.meshMaleen_GB
dc.subject.meshMiddle Ageden_GB
dc.subject.meshProstatic Hyperplasia/complications/surgeryen_GB
dc.subject.meshTransurethral Resection of Prostateen_GB
dc.subject.meshUrinary Catheterizationen_GB
dc.subject.meshUrinary Retention/etiology/*therapyen_GB
dc.subject.meshUrinationen_GB
dc.titleManagement outcome of acute urinary retention: model of prediction.en_GB
dc.contributor.departmentDepartment of Urology, Mercy University Hospital, University College Cork, Cork, , Ireland.en_GB
dc.identifier.journalUrologia internationalisen_GB
dc.description.provinceMunster-
All Items in Lenus, The Irish Health Repository are protected by copyright, with all rights reserved, unless otherwise indicated.