Management of acute urinary retention: a worldwide survey of 6074 men with benign prostatic hyperplasia.

摘要: OBJECTIVES To evaluate the management of acute urinary retention (AUR) associated with benign prostatic hyperplasia (BPH) in real-life practice. To identify predictors successful trial without catheter (TWOC). MATERIALS AND METHODS In all, 6074 men catheterized for painful AUR were enrolled a prospective, cross-sectional survey conducted public and private urology practices France, Asia, Latin America, Algeria Middle East. Patient clinical characteristics, type its (type catheterization, hospitalization, TWOC, use α1-blockers, immediate or elective surgery) adverse events observed during catheterization period recorded. Predictors TWOC success also analysed by multivariate regression analysis stepwise procedure. RESULTS Of men, 4289 (71%) had spontaneous 1785 (29%) precipitated AUR, mainly as result loco-regional/general anaesthesia (28.5%) excessive alcohol intake (18.2%). Presence BPH was revealed 44% men. Hospitalization varied between countries, ranging from 1.7% to 100% France. A urethral inserted most cases (89.8%) usually followed (78.0%) after median 5 days. Overall rate 61%. Most (86%) received an α1-blocker (mainly alfuzosin) before removal consistently higher rates, regardless age AUR. Multivariate confirmed that doubled chances (odds ratio 1.92, 95% CI 1.52–2.42, P < 0.001). Age ≥70 years, prostate size ≥50 g, severe lower tract symptoms, drained volume at ≥1000 mL favoured failure. Catheterization >3 days did not influence but increased morbidity prolonged hospitalization events. In case failure, 49% recatheterized surgery 43.5% tried another 29.5%. Elective preferred surgery. CONCLUSIONS TWOC has become standard practice worldwide AUR. In cases, is prescribed significantly increases chance success. Prolonged morbidity.