Prospective study of bladder wall thickness in predicting the success rate of trial without catherer in acute urinary retention secondary to benign prostatic hyperplasia

Abstract

Acute urinary retention (AUR) is one of the most common urological emergencies and is usually caused by benign prostatic hyperplasia (BPH). Trial without catheter (TWOC) is a common practice in AUR secondary to BPH although it is not always successful in all patients. We conducted this prospective study to predict bladder wall thickness (BWT) as a factor to predict the success or failure rate of TWOC in this subset of patients. Other factors which includes baseline international prostate symptom score (IPSS), volume of urine drained immediately after catheterization (Drained Urine), prostate volume (PV), intravesical prostate protrusion (IPP) and PSA level were also assessed. Twenty-nine patients with first episode of AUR secondary to BPH were enrolled in this study. These patients were given alfuzosin 10mg daily and a transabdominal ultrasound is performed prior to TWOC on day ten. The aforementioned factors were then recorded. The demographic and clinical characteristics were determined using descriptive statistics. BWT and other factors in predicting the success or failure rate of TWOC were analyzed using simple and multiple logistic regression. TWOC was successful in 15 (51.7%) and failed in 14 (48.3%) patients. BWT has no statistical significance in predicting the success rate of TWOC; including IPSS, drained urine, IPP and PSA level. We found out age and PV are factors that are significant in predicting the failure rate of TWOC (p<0.05), with an odds ratio of 16.29 and 13.12.