Causual analysis of liquid leakage from the urethral meatus and nursing intervention in patients indwelled with urinary catheter after transurethral resection of the prostate

Abstract

Objective To investigate the causes of liquid leakage from the urethral meatus in patients indewelled with urinary catheter after transurethral resection of the prostate(TURP), and provide the basis for improving the nursing quality. Methods A retrospective study was conducted in 179 patients who underwent TURP from January 2015 to February 2018. Data included in the analysis were age, IPSS, storage and voiding symptom scores (IPSS-S, IPSS-V), QoL, maximum free flow rate (Qmax), post-voided residual urine volume, first sensation of bladder filling(FS), bladder compliance(BC), BC grade, maxmium cystometric capacity(MCC), MCC grade, maximum detrusor pressure, detrusor pressure at Qmax, obstruction grade, detrusor overactivity(DO) and detrusor underactivity(DUA). Acorrding to the status of liquid leakage from the urethral meatus after TURP, patients were divided into leakage positive (LP) and negative(LN) groups. The above mentioned parameters were compared between the two groups and these with statistical significance were further analyzed in the Logistic regression model. Results There were 76 and 103 patients in LP and LN groups, respectively. There were significant differences in age, IPSS score, IPSS-S score, BC score, BC grade, FS score, MCC score, MCC grade, Qmax and the prevalence of DO between LP and LN groups [(72.9±7.1)years old vs. (67.9±6.8)years old, (23.7±5.7)vs. (20.9±6.7), (11.4±2.9)vs.(8.8±3.3), 10.5 (5.6, 16.4) ml/cmH2O vs.37.0 (24.3, 57.3) ml/cmH2O, (3.6±3.3)vs. (9.4±5.0), (85.2±53.2)ml vs.(130.8±69.7)ml, (161.6±97.5) ml vs. (323.7±163.6)ml, (3.8±2.0)vs.(6.7±2.5), (6.1±2.8)ml/s vs.(7.4±3.3)ml/s, 57.9% (44/76) vs.17.4% (18/103)] (P<0.05 for each). Logistic regression analysis showed that high IPSS-S (OR=1.617, P=0.001), DO (OR=3.615, P=0.024), MCC (OR=0.591, P=0.002) and BC grades (OR=0.745, P=0.001) were risk and protective factors of liquid leakage from the urethral meatus after TURP. Conclusion When indwelled with urinary catheter, the patients with high IPSS-S, low MCC, low BC, and DO have high risks of liquid leakage from the urethral meatus after TURP. For these patients, we should give psychological guidance, and inform them of disease condition preoperatively; and after surgery we should take appropriate measures to improve nursing quality. Key words: Transurethral resection of prostate; Urethra; Nursing care; Leakage