Urodynamic Results of Acute Urinary Retention after Trial without Catheter

 

Purpose

Acute urinary retention (AUR) is a serious complication of male with lower urinary tract symptoms (LUTS).

But, we still do not know the urodynamic characteristics of AUR. We performed urodynamic study after trial without catheter (TWOC) to know the urodynamic characteristics of AUR.

Materials and Methods

From Feb. 2006 to April 2007, we performed 75 multi-channel urodynamic studies on male with LUTS including 11 AUR patients. In AUR patients, Pressure flow study (PFS) was performed after TWOC. We reviewed medical records of AUR patients, analyzed UDS parameters and compared UDS parameters with non- AUR LUTS patients. The patients having acute or chronic neuropathy were excluded. PFS was done at sitting position.

Results

Of 11 AUR patients, 5 patients have combined medical disease, hypertension (2 pts.), diabetes (1pt.), lung cancer (1pt.), chronic renal disease, diabetes, hypertension (1 pt.). Two patients are precipitated AUR (18.2%, 2/11), 9 patients are spontaneous AUR (81.9%, 9/11). Seven patients succeed on TWOC (63.7%, 7/11), 4 patients failed on TWOC (36.4%, 4/11). Average maximal detrusor pressure on filling phase (pdetMax) was 12.9±10.8cmH20. One 7 TWOC success patients (14.3%, 1/7) showed increased pdetMax than average pdetMax. On the contrary, 3 of 4 TWOC failure patients (75.0%, 3/4) showed increased pdetMax than average pdetMax. The average first desire, normal desire, strong desire, compliance and maximal capacity of 11 AUR patients were 199.0°æ98.4ml, 363.5°æ101.4ml, 442.9°æ125.8ml, 81.5°æ81.3, 540.2°æ161.0ml, respectively. The average first desire, normal desire, strong desire, compliance and maximal capacity of 64 patients with non-AUR LUTS were 185.0°æ105.2ml (P=0.7), 260.0°æ123.4ml (P=0.01), 358.6°æ154.3ml (P=0.18), 92.0°æ104.3 (P=0.75), 385.7°æ171.0ml (P=0.007), respectively.

Conclusions

Although we still do not know the exact reason, AUR patients showed more delayed normal desire and more enlarged maximal capacity than that of LUTS patients without AUR. Patients with success on TWOC tend to show lower pdetMax than that of TWOC failure patients during filling cystometry.

Keywords

Urodynamcis, acute urinary retention

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