Best nonsurgical managements of acute urinary retention: what's new?

To provide a comprehensive review of the non-surgical management of acute urinary retention (AUR).

A recent meta-analysis confirmed that α-blockers are associated to higher rates of successful trial without catheter (TWOC) compared to placebo, while combination therapies do not significantly reduce the rate of recatheterization. Compared to standard TWOC, bladder perfusion with saline prior to catheter removal is a simple and cost-effective method to increase TWOC success rates (OR 2.41, 95%CI 1.53-3.8), and to reduce time-to-discharge (-89.68 min, 95%CI -160.55, -18.88). Clean intermittent catheterization (CIC) is increasingly used for urinary retention in patients with BPH as existing data suggest that it may decrease the risk of urinary tract infections, accelerate spontaneous voiding recovery and might be more cost-effective compared to indwelling urethral catheterization. Ongoing trials are examining whether office-placed prostate stent may be a promising solution in patients with AUR.

The recent development of alternative approaches to traditional TWOC may lead to new therapies for treating patients with AUR. Further studies are needed as the level of evidence from published studies remains low.

Current opinion in urology. 2021 Dec 24 [Epub ahead of print]

Michael Baboudjian, Peyronnet Benoit, Romain Boissier, Grégoire Robert, Jean-Nicolas Cornu, Vincent Misrai, Benjamin Pradere

Department of Urology, La Conception Hospital, Aix-Marseille University, APHM, Marseille, France Department of Urology, North Hospital, Aix-Marseille University, APHM, Marseille, France Department of Urology, University of Rennes, Rennes, France Department of Urology, Bordeaux Pellegrin University Hospital, Bordeaux, France Department of Urology, Charles Nicolle University Hospital, Rouen Cedex, France Department of Urology, Clinique Pasteur, Toulouse, France Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.

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