Acute urinary retention management in department of emergency urology

Abstract

Aim. Reduce the treatment costs for patients with acute urinary retention, as well as prevention of intra- and postoperative complications.
 Methods. Since January 1st, 2014 to December 31st, 2014, 3760 patients were examined in the urology department of the Municipal Hospital №5, including 114 (3.2%) patients with acute urinary retention, of whom 100 (2.8%) had the first episode of acute urinary retention, 14 (0.4%) - the relapse. In the first group of 81 (71%) patients with uncomplicated acute urinary retention, a permanent urethral catheter was inserted; patients were further treated as outpatients. The patients of the second group (33 patients, 29%) with complicated acute urinary retention were admitted in the department of urology. The age of the examined patients ranged from 50 to over 80 years, the mean age was 65 years. The analysis of the treatment costs in patients with acute urinary retention was performed, with the treatment costs calculated by the economical department of the Municipal Hospital №5. The average cost of 1-day stay in the department of urology in 2014 was 1416 rubles.
 Results. The management tactics, allowing to reduce the treatment costs, as well as to reduce the number of intra- and postoperative complications, was proposed. If 100% of patients with acute urinary retention were admitted, the total treatment cost would be 807 120 rubles. The used approach reduced this costs to 118 944 rubles, with the economical effect of 688 176 rubles in 2014.
 Conclusion. The used strategy of treating patients with acute urinary retention decreases the healthcare expenses on treating this condition, as well as decreases the risk for lower urinary tract infection and excludes the possibility of nosocomial infections.