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Titolo:
A prospective study of conservatively managed acute urinary retention: prostate size matters
Autore:
Kumar, V; Marr, C; Bhuvangiri, A; Irwin, P;
Indirizzi:
Leighton Hosp, Michael Heal Dept Urol, Crewe CW1 4QJ, Cheshire, England Leighton Hosp Crewe Cheshire England CW1 4QJ e CW1 4QJ, Cheshire, England
Titolo Testata:
BJU INTERNATIONAL
fascicolo: 7, volume: 86, anno: 2000,
pagine: 816 - 819
SICI:
1464-4096(200011)86:7<816:APSOCM>2.0.ZU;2-#
Fonte:
ISI
Lingua:
ENG
Soggetto:
MEN;
Keywords:
acute retention of urine; benign prostatic enlargement; trial without catheter; conservative treatment;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
6
Recensione:
Indirizzi per estratti:
Indirizzo: Kumar, V Leighton Hosp, Michael Heal Dept Urol, Crewe CW1 4QJ, Cheshire, England Leighton Hosp Crewe Cheshire England CW1 4QJ , Cheshire, England
Citazione:
V. Kumar et al., "A prospective study of conservatively managed acute urinary retention: prostate size matters", BJU INT, 86(7), 2000, pp. 816-819

Abstract

Objective To evaluate in a prospective study the medium- to long-term outcome of a policy of conservatively managing acute urinary retention (AUR), arising solely by bladder outlet obstruction caused by benign prostatic enlargement (BPE), and to identify the factors favouring a positive outcome of a trial without catheter (TWOC). Patients and methods All men admitted as an emergency with primary AUR caused by BPE (from August 1997 to March 2000) underwent a TWOC. The followingvariables were recorded; the nature and duration of any preceding lower urinary tract symptoms, previous episodes of retention, concomitant anticholinergic medication, coexisting constipation, alcohol as a precipitating cause of AUR, previous prostatectomy, confirmed urinary tract infection, residual urine drained on catheterization and prostate size, as determined by a digital rectal examination (DRE) carried out by one consultant urologist in all patients. Those voiding successfully were followed up prospectively using the International Prostate Symptom Score (IPSS), quality-of-life score, urinary flow rate measurement and ultrasonographic measurement of the postvoid residual (PVR). Results Of the 40 men with AUR, 22 (55%) voided spontaneously after removing the catheter and continued to do so with mean peak flow rates of 12.2 mL/s and mean PVRs of 69.6 mL over a follow-up of 8-24 months. These patientsremained asymptomatic, with a mean IPSS of 5.2 and quality-of-life score of 0.9. These men had a mean prostatic size of 15.9 g and a mean catheterized residual volume of 814 mL, while in those who had an unsuccessful TWOC the mean prostate size was 27.5 g (P = 0.006) and a mean catheterized residual volume of 1062 mL (P = 0.09). Prostate size as assessed by the DRE was the most significant factor in predicting the outcome of a TWOC. Conclusion A TWOC is justified in the long-term for men presenting with AUR caused by BPE. Prostate size is the most important factor for predicting the outcome of such a trial.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 29/03/20 alle ore 23:47:35