Predictive variables of spontaneous micturition recovery after acute urinary retention in men with benign prostatic enlargement: An observational prospective study

• Published in: Lower urinary tract symptoms 2019-05, Vol.11 (3), p.104-108
• Main Authors: Vella, Marco, Abrate, Alberto, Costanzo, Angela, D'Amato, Francesco, Tarantino, Maria L., Simonato, Alchiede
• Format: Article
• Language: English
• Subjects: Acute Disease; acute urinary retention; Aged; Area Under Curve; C-Reactive Protein - metabolism; C‐reactive protein; Humans; International Prostate Symptom Score; Intubation; Male; Middle Aged; Organ Size; Prospective Studies; Prostate; Prostate - pathology; Prostatic Hyperplasia - complications; Prostatic Hyperplasia - pathology; Recovery of Function; Retention; ROC Curve; Severity of Illness Index; spontaneous micturition recovery; Urinary Catheterization; Urinary Retention - etiology; Urinary Retention - physiopathology; Urinary Retention - therapy; Urination
• ISSN: 1757-5664; 1757-5672
• DOI: 10.1111/luts.12241

Objective Acute urinary retention (AUR) is the sudden and painful inability to urinate spontaneously. AUR is one of the most significant complications of benign prostatic enlargement. The management of AUR is based on transurethral catheterization. Subsequent therapy is uncertain, but AUR seems to benefit from the use of alpha‐blockers. The aim of this study was to evaluate the variables that could predict which patients would recover spontaneous micturition after trial without catheter. Methods The present prospective observational study included men with AUR in an Italian tertiary care institute in 2016. Patients were catheterized and treated orally with fluoroquinolones, alpha‐blockers, and Serenoa repens extracts. Preoperative variables as age, C‐reactive protein (CRP), previous prostate‐specific antigen values, urinary retention volume, prostate volume, and scores on a modified International Prostate Symptom Score questionnaire (IPSS‐4), were investigated in relation to spontaneous micturition recovery. Results Mean (±SD) age was 68.4 ± 7.1 years. Spontaneous and valid micturition recovery was observed in 11 patients (29.7%), whereas 26 (70.3%) needed to be catheterized again. The IPSS‐4 score was significantly lower (9 vs 17; P