Retrospective analysis of management of patients presenting with acute urinary retention due to benign prostatic hyperplasia: A hospital based study (original) (raw)
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Journal of Patan Academy of Health Sciences, 2021
Introduction: Acute urinary retention (AUR) is an important public health issue in older male population with benign prostatic hyperplasia (BPH). Various risk factors are associated with increased incidence of AUR among patients with BPH being managed conservatively. Method: A retrospective analysis was performed AUR with BPH among patients in Shree Birendra Hospital (SBH), Chhauni, Kathmandu, Nepal for a period of one year. Study variables included patient age, serum prostate specific antigen (PSA), prostate volume, history of AUR, smoking, diabetes mellitus, hypertension, cardiovascular disease, and other comorbid diseases. The SPSS was used for data analysis, X2 test to find out the association and a p<0.05 considered statistically significant. The study was approved from the ethical committee. Result: Total 110 patients (out of 182 BPH) had AUR, an incidence of 60.9% (110 out of 182), with a mean (SD) age of 67.41±7.1 (p<0.05). Patients with AUR had larger mean prostate ...
International Surgery Journal
Background: Acute urinary retention (AUR) is one of the most psychologically distressing complications of benign prostatic hypertrophy (BPH). Attempt of trial without urinary catheter (TWOC) is given to all these patients, failing which they are subjected to surgical management. This study was conducted to analyse the possible predictors of successful trials in such patients.Methods: Patients reporting to our centre with a first episode of spontaneous AUR secondary to BPH were enrolled. Following per-urethral catheterization residual urine volume (RUV) drained, duration of symptoms and international prostate symptom score (IPSS) were recorded. Using trans-abdominal ultrasonography (USG) prostate volume (PV), intra-vesicle prostate protrusion (IPP) and bladder wall thickness (BWT) were measured. Catheter free trial was given after a course of tamsulosin. Success was defined if patients could void >200 ml of urine within six hours of catheter removal with a maximum flow rate of >...
Urology journal, 2014
PURPOSE To compare the efficacy and safety of single (tamsulosin) and double dose (tamsulosin + alfuzosin) alpha-blocker therapy for treating catheterized patients with acute urinary retention (AUR) due to benign prostatic hyperplasia (BPH). MATERIALS AND METHODS Seventy patients with AUR due to BPH were catheterized and randomized into two groups: the single dose group (0.4 mg tamsulosin, 35 patients) and the double dose group (0.4 mg tamsulosin + 10 mg alfuzosin, 35 patients). The catheter was removed after 3 days, and the patients were put on trial without catheter (TWOC). RESULTS Seventy males (mean age, 71.2 years) were randomly assigned to receive double or single dose alpha-blocker (35 patients per group). The intent-to-treat population consisted of 70 males. Twenty-seven individuals in the double dose group and 19 in the single dose group did not require re-catheterization on the day of the TWOC (77% and 54%, respectively; P = .003). Success using free-flow variables was als...
Scholars Journal of Applied Medical Sciences
Original Research Article Acute urinary retention (AUR) is a urological emergency and can affect about 5-25 per 1000 person years. It accounts for one third of patients requiring surgery for benign prostatic hyperplasia (BPH). The initial management of AUR is per urethral catheterization for bladder decompression following which patients are advised alpha blocker and called for trial of voiding without catheter at a later date. If the trial without catheter (TWOC) fails, one may need surgical intervention. The objective of our study was to assess whether the grade of intravesical prostatic projection (IPP) can predict the outcome of TWOC following an episode of AUR. A total of ninety patients coming to our outdoor in a study period of one year were included. It was observed that the failure rate of TWOC of grade III IPP was significantly higher compared to grade I and grade II but age and prostate volume had no significant impact on the outcome of TWOC in these patients. We conclude that IPP is a strong predictor of the outcome of TWOC in patients with AUR due to BPH.
Benign prostatic hyperplasia morphological parameters for assessing risk of acute urinary retention
African Journal of Urology
Aim of the study To evaluate objective measurements of morphological changes of the prostate in Benign Prostatic Hyperplasia (BPH) as predictors of acute urinary retention (AUR). Methods Overall 169 consecutive patients older than 50 years of age were prospectively divided into group A (n = 61); men with acute urinary retention (AUR), or group B (n = 108); men with different degrees of lower urinary tract symptoms (LUTS). Transrectal ultrasound (TRUS) measurements of total prostate volume (TPV), transitional zone volume (TZV), ratio of TZV to TPV (TZV/TPV), and vesico-urethral angle (VUA) were recorded. Group B patients also had post-void residual (PVR) and maximum flow rate (Q-max) recorded. TZV/TPV and VUA were correlated with Q-max and PVR, and a comparison was made between the two groups. Results Group A had significantly larger TPV (p = 0.03) and TZV/TPV (p = 0.04) compared to Group B. VUA in Group A had a significant correlation with AUR (p = 0.02). In Group B, both TZV/TPV an...
2021
Background: Benign prostatic hyperplasia (BPH) is the commonest cause of bladder outlet obstruction (BOO) in elderly males. It is characterised by lower urinary tract symptoms (LUTS) that include voiding/obstructive and storage/irritative symptoms. If untreated, patients could suffer from different associated complications such as hydronephrosis, urinary tract infection and even renal failure. Little is known about the magnitude and pattern of associated complications of BOO secondary to BPH.Objectives: To assess the clinical profile, magnitude and pattern of associated complications of BOO among patients with BPH at Yekatit 12 hospital, Addis Ababa, Ethiopia.Methods: A retrospective crossectional hospital based analysis of 225 patients who underwent prostatectomy for BOO secondary to BPH over a five year period, from January 1, 2015 to December 31, 2019 was done. Data were analysed using SPSS version 20. Results: Frequency of micturition, dysuria and nocturia were the commonest pre...
Malaysian Journal of Medical Sciences
Patients with Benign Prostatic Hyperplasia (BPH) commonly presents with lower urinary tract symptoms (LUTS), which can be of obstructive symptoms such as hesitancy, incomplete voiding, post void dribbling or of irritative symptoms such as urgency, frequency and nocturia. Various recent studies indicate that nocturia is a very important and bothersome lower urinary tract symptom especially among patients with Benign Prostatic Hyperplasia (BPH). The aims of the study was to determine the frequency of common urinary symptoms among patients with BPH in HUSM as well as to evaluate the extent of bothersomeness of each and every symptom to these patients. This study too was aimed at evaluating the success of TURP in resolving pre operative LUTS. This was a questionnaire-based survey using a validated ICSBPH model whereby patients with BPH were selected and quizzed personally by an investigator. A subset of patients who had undergone TURP were further questioned regarding their satisfaction with the procedure. When nocturia is defined as waking up at night once or more to pass urine, the prevalence of nocturia was about 90%, but only 1 in 6 patients considered this is a very serious symptom. Even if the definition was changed to waking up twice or more, the prevalence is still quite high at over 80%. Urgency were noted in half of the patients, but only a quarter of them consider it a serious problem. 1 in 5 patients experienced significant leak and almost all consider it serious. About one third of the studied population had to be catheterized due to urinary obstruction and interestingly only about half of them considered it as a very serious event. Overall, a great majority of these patients considered suffering from these urinary symptoms for the rest of their life as very devastating. This study conclude that although the prevalence of nocturia was high among BPH patients, but it was not considered serious by majority of them. In fact, LUTS in our BPH patients did not differ much from BPH patients elsewhere. On the whole, TURP resolved most of the LUTS effectively.
Urology journal, 2009
The failure of prostate-directed treatment modalities to help all men or all symptoms has questioned the longstanding assumption that the prostate is at the root of all male urinary symptoms, and a correlation between urinary bladder function and prostate pathology has been recognized. Now, it is widely recognized that bladder dysfunction plays a role in some, if not most, of the benign prostatic hyperplasia-related symptoms and signs, and recent studies have suggested that pharmacotherapies that target the bladder, such as antimuscarinics, may improve storage urinary symptoms. Indeed, the current mainstays of overactive bladder syndrome pharmacotherapy are antimuscarinic agents with mixed actions, including musculotropic (calcium antagonistic) activity. Moreover, the combination therapy with alpha blocker and antimuscarinic agents is now suggested when bladder outlet obstruction related to benign prostatic hyperplasia coexists with overactive bladder symptoms. Combinational treatme...
Cureus, 2023
Background: Benign prostatic hyperplasia (BPH) is a progressive disease that causes low urinary tract symptoms (LUTS). As prostatic volume grows, the prostatic urethra may become completely obstructed, resulting in full urine retention and acute hypogastric pain. Our research aimed to identify the optimal trial without catheter (TWOC) therapeutic approach and identify those factors that are associated with the recurrence of complete urinary retention (CUR). Methodology: The study enrolled with complete urinary retention and BPH were included in the study, after the insertion of a Foley catheter. The patients received tamsulosin 0.4 mg/day as an alpha-blocker treatment. In our investigation, patients who encountered complete urinary retention were randomly categorized into four groups based on the duration of urinary catheterization as determined by the attending urologist. Results: Maintaining the urethrovesical catheter for three to seven days was related to the highest success of spontaneous urination, which was statistically significant compared to other study groups. (p=0.0007). Age over 70 years, no alpha-blocker before the urinary retention episode, and prostatic volume exceeding 50 ml were all associated with decreased TWOC efficacy. We found the highest rates of spontaneous urination were after three to seven days of urinary catheterization. Conclusion: BPH and complete urine retention can be managed by TWOC in many cases. Several factors affect the test's efficacy. Prolonged urinary catheter maintenance over seven days, prostatic volume over 50 ml, and age over 70 years are poor prognostic indicators.