Predictors of Successful Trial without Catheter in Patients with benign Prostatic Obstruction

Abstract

Objectives: One of the clinical presentations of benign prostatic enlargement (BPE) is acute urinary retention (AUR), and these patients are treated with per urethral catheterization. Trial without catheterization is the next step in these patients and involves administering an alfa blocker and removal of the catheter after 3 days. We studied these patients for identifying the possible factors that predict the success of trial voiding without catheter (TWOC).

Methods: Patients with an episode of AUR due to BPE were assessed with detailed history, physical examination and ultrasonography. All patients were catheterized and treated with an alfa blocker. All patients satisfying the inclusion criteria were given TWOC. Outcomes were correlated with factors such as age of the patient, prostate size, type of AUR, alfa blocker used and duration of catheterization.

Results: A total of 162 patients were included in the study. Patients younger than 60 years showed success rate of 73% compared to 48% in older patients (p 0.004), prostate size of less than 50grams showed a success of 66% compared to 48% in larger glands (p 0.02) and precipitated AUR had 80% success compared to 52% in spontaneous group (p 0.007). Duration of catheterization and specific type of alfa blocker were not significant factors for successful TWOC in our study.

Conclusion: Younger age, smaller prostate and precipitated AUR favour success of TWOC.