Skip to main content

Advertisement

SpringerLink
Log in

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

  • Original Article
  • Published:
Irish Journal of Medical Science (1971 -) Aims and scope Submit manuscript

Abstract

Background

Acute urinary retention (AUR) is a common urologic emergency. However, its management is not standardized due to lack of clinical guidelines.

Aims

We retrospectively reviewed the treatment of all male patients admitted to our institution with AUR over 12 months.

Methods

Data was obtained from the HIPE (Hospital Inpatient Enquiry) data system, each patient’s electronic discharge summary and from patient medical records.

Results

There were 130 AUR admissions during the period. About 74 admissions were due to benign prostatic enlargement (BPE). Of these, 45.9% (n = 34) passed their trial without catheter (TWOC). The remainder (n = 40) failed their TWOC necessitating recatheterization and consideration for transurethral resection of prostate (TURP) or re-TWOC. An indwelling urinary catheter (IDC) was inserted for 27.5% (n = 11) of patients with a failed TWOC secondary to comorbidities. This group had a mean age of 78 years (range 68–96 years). Of those who failed their TWOC, 32.5% (n = 13) had a TURP on index admission. Of the remaining 16 patients with failed TWOC, 75% (n = 12) were discharged with an IDC and readmitted for an elective TURP with a median waiting time of 55 days (range 17–138 days). 18.75% (n = 3) passed a re-TWOC and thus offset the need to have any surgical intervention and 6.25% (n = 1) proceeded to a radical retropubic prostatectomy for biopsy proven prostate adenocarcinoma.

Conclusion

Admission of patients with acute urinary retention leads to a definitive management decision and reduced prolonged catheterization.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Izard J, Nickel JC (2011) Impact of medical therapy on transurethral resection of the prostate: two decades of change. BJU Int 108(1):89–93

    PubMed  Google Scholar 

  2. Kolman C, Girman CJ, Jacobsen SJ, Lieber MM (1999) Distribution of post-void residual urine volume in randomly selected men. J Urol 161(1):122–127

    CAS  PubMed  Google Scholar 

  3. Muruganandham K, Dubey D, Kapoor R (2007) Acute urinary retention in benign prostatic hyperplasia: risk factors and current management. Indian J Urol 23(4):347–353

    CAS  PubMed  PubMed Central  Google Scholar 

  4. Roehrborn CG (2001) The epidemiology of acute urinary retention in benign prostatic hyperplasia. Rev Urol 3(4):187–192

    CAS  PubMed  PubMed Central  Google Scholar 

  5. Jacobsen SJ, Jacobson DJ, Girman CJ, Roberts RO, Rhodes T, Guess HA, Lieber MM (1997) Natural history of prostatism: risk factors for acute urinary retention. J Urol 158(2):481–487

    CAS  PubMed  Google Scholar 

  6. Kaplan S, Garvin D, Gilhooly P, Koppel M, Labasky R, Milsten R, Reddy P, Rosenberg S, Sussman D, White C, Lee M, Pappas F, Waldstreicher J (2000) Impact of baseline symptom severity on future risk of benign prostatic hyperplasia-related outcomes and long-term response to finasteride. The Pless study group. Urology 56(4):610–616

    CAS  PubMed  Google Scholar 

  7. Marberger MJ, Andersen JT, Nickel JC, Malice MP, Gabriel M, Pappas F, Meehan A, Stoner E, Waldstreicher J (2000) Prostate volume and serum prostate-specific antigen as predictors of acute urinary retention. Combined experience from three large multinational placebo-controlled trials. Eur Urol 38(5):563–568

    CAS  PubMed  Google Scholar 

  8. McConnell JD, Bruskewitz R, Walsh P, Andriole G, Lieber M, Holtgrewe HL, Albertsen P, Roehrborn CG, Nickel JC, Wang DZ, Taylor AM, Waldstreicher J (1998) The effect of finasteride on the risk of acute urinary retention and the need for surgical treatment among men with benign prostatic hyperplasia. Finasteride long-term efficacy and safety study group. N Engl J Med 338(9):557–563

    CAS  PubMed  Google Scholar 

  9. Meigs JB, Mohr B, Barry MJ, Collins MM, McKinlay JB (2001) Risk factors for clinical benign prostatic hyperplasia in a community-based population of healthy aging men. J Clin Epidemiol 54(9):935–944

    CAS  PubMed  Google Scholar 

  10. Emberton M, Fitzpatrick JM (2008) The Reten-world survey of the management of acute urinary retention: preliminary results. BJU Int 101(Suppl 3):27–32

    PubMed  Google Scholar 

  11. Groves HK, Chang D, Palazzi K, Cohen S, Parsons JK (2013) The incidence of acute urinary retention secondary to BPH is increasing among California men. Prostate Cancer Prostatic Dis 16(3):260–265

    CAS  PubMed  Google Scholar 

  12. Armitage JN, Sibanda N, Cathcart PJ, Emberton M, van der Meulen JH (2007) Mortality in men admitted to hospital with acute urinary retention: database analysis. BMJ 335(7631):1199–1202

    PubMed  PubMed Central  Google Scholar 

  13. Bootsma AM, Buurman BM, Geerlings SE, de Rooij SE (2013) Urinary incontinence and indwelling urinary catheters in acutely admitted elderly patients: relationship with mortality, institutionalization, and functional decline. J Am Med Dir Assoc 14(2):147.e147–147.e112

    Google Scholar 

  14. Fitzpatrick JM, Desgrandchamps F, Adjali K, Gomez Guerra L, Hong SJ, El Khalid S, Ratana-Olarn K (2012) Management of acute urinary retention: a worldwide survey of 6074 men with benign prostatic hyperplasia. BJU Int 109(1):88–95

    PubMed  PubMed Central  Google Scholar 

  15. Lo KL, Chan MC, Wong A, Hou SM, Ng CF (2010) Long-term outcome of patients with a successful trial without catheter, after treatment with an alpha-adrenergic receptor blocker for acute urinary retention caused by benign prostatic hyperplasia. Int Urol Nephrol 42(1):7–12

    CAS  PubMed  Google Scholar 

  16. Yoon PD, Chalasani V, Woo HH (2015) Systematic review and meta-analysis on management of acute urinary retention. Prostate Cancer Prostatic Dis 18(4):297–302

    CAS  PubMed  Google Scholar 

  17. McPherson K, Devlin HB (1995) The National Prostatectomy Audit: the clinical management of patients during hospital admission. Br J Urol 75(3):301–316

    PubMed  Google Scholar 

  18. Neal DE (1997) The National Prostatectomy Audit. Br J Urol 79(S2):69–75

    PubMed  Google Scholar 

  19. Pickard R, Emberton M, Neal DE (1998) The management of men with acute urinary retention. National Prostatectomy Audit Steering Group. Br J Urol 81(5):712–720

    CAS  PubMed  Google Scholar 

  20. Fitzpatrick JM, Kirby RS (2006) Management of acute urinary retention. BJU Int 97(Suppl 2):16–20 discussion 21-12

    PubMed  Google Scholar 

  21. Manikandan R, Srirangam SJ, O'Reilly PH, Collins GN (2004) Management of acute urinary retention secondary to benign prostatic hyperplasia in the UK: a national survey. BJU Int 93(1):84–88

    CAS  PubMed  Google Scholar 

  22. Kunin CM, Douthitt S, Dancing J, Anderson J, Moeschberger M (1992) The association between the use of urinary catheters and morbidity and mortality among elderly patients in nursing homes. Am J Epidemiol 135(3):291–301

    CAS  PubMed  Google Scholar 

  23. Desgrandchamps F, De La Taille A, Doublet JD (2006) The management of acute urinary retention in France: a cross-sectional survey in 2618 men with benign prostatic hyperplasia. BJU Int 97(4):727–733

    PubMed  Google Scholar 

  24. Central Statistics Office CDD16: population aged 65 years and over by age group, sex, province county or city, census year and statistic. http://www.cso.ie/px/pxeirestat/Statire/SelectVarVal/Define.asp?Maintable=CDD16&Planguage=0 . Accessed 04/01/2017.2017

  25. Cravens DD, Zweig S (2000) Urinary catheter management. Am Fam Physician 61(2):369–376

    CAS  PubMed  Google Scholar 

  26. McNeill SA, Daruwala PD, Mitchell ID, Shearer MG, Hargreave TB (1999) Sustained-release alfuzosin and trial without catheter after acute urinary retention: a prospective, placebo-controlled. BJU Int 84(6):622–627

    CAS  PubMed  Google Scholar 

  27. Nasr A, Reichardt K, Fitzgerald K, Arumugusamy M, Keeling P, Walsh TN (2004) Impact of emergency admissions on elective surgical workload. Ir J Med Sci 173(3):133–135

    CAS  PubMed  Google Scholar 

  28. Robb WB, O'Sullivan MJ, Brannigan AE, Bouchier-Hayes DJ (2004) Are elective surgical operations cancelled due to increasing medical admissions? Ir J Med Sci 173(3):129–132

    CAS  PubMed  Google Scholar 

  29. Cullen IM, Dowling CM, Thornhill JA, Grainger R (2012) Emergency management of acute urinary retention: results from an all-Ireland urologist practice survey. Ir J Med Sci 182(2):207–211

    PubMed  Google Scholar 

  30. Teoh JY, Kan CF, Tsui B, Chiu PK, Man CY, Hou SS, Ng CF (2012) Ambulatory care program for patients presenting with acute urinary retention secondary to benign prostatic hyperplasia. Int Urol Nephrol 44(6):1593–1599

    PubMed  Google Scholar 

  31. Modi P, Pleat J, Cheetham P, Senior J, Johan R, Fellows GJ (2000) A 23-year review of the management of acute retention of urine: progressing or regressing? Ann R Coll Surg Engl 82(5):333–335

    CAS  PubMed  PubMed Central  Google Scholar 

  32. Khoubehi B, Watkin NA, Mee AD, Ogden CW (2000) Morbidity and the impact on daily activities associated with catheter drainage after acute urinary retention. BJU Int 85(9):1033–1036

    CAS  PubMed  Google Scholar 

  33. Hallett JM, Stewart GD, McNeill SA (2013) The management of acute urinary retention: treating the curse of the aging male. Current Bladder Dysfunction Reports 8(3):242–249

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Urology, St. Vincent’s University Hospital (SVUH), Elm Park, Dublin 4, Ireland

    Paul Christopher Ryan, Éanna J. Ryan, Robert A. Keenan, Usman M. Haroon, Mark P. Broe, James C. Forde, David Galvin, Gerry M. Lennon, Michael Murphy, David M. Quinlan & David W. Mulvin

Authors
  1. Paul Christopher Ryan
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Éanna J. Ryan
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Robert A. Keenan
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Usman M. Haroon
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Mark P. Broe
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. James C. Forde
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. David Galvin
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Gerry M. Lennon
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Michael Murphy
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. David M. Quinlan
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. David W. Mulvin
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Paul Christopher Ryan.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ryan, P.C., Ryan, É.J., Keenan, R.A. et al. Admission of patients with acute urinary retention leads to a definitive management decision. Ir J Med Sci 189, 999–1003 (2020). https://doi.org/10.1007/s11845-019-02164-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11845-019-02164-8

Keywords

Search

Navigation