MP74-09 SURGICAL OUTCOMES IN CATHETER-DEPENDENT MEN DUE TO URINARY RETENTION

Abstract

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Non-neurogenic Voiding Dysfunction I1 Apr 2016MP74-09 SURGICAL OUTCOMES IN CATHETER-DEPENDENT MEN DUE TO URINARY RETENTION Christine Liaw, Lucas Policastro, and Jerry Blaivas Christine LiawChristine Liaw More articles by this author , Lucas PolicastroLucas Policastro More articles by this author , and Jerry BlaivasJerry Blaivas More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.1706AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Men who develop urinary retention require an indwelling catheter or self intermittent catheterization as a temporary measure until successful treatment is achieved or as permanent treatment when surgery is not recommended. The aim of this study is to compare urodynamic findings and surgical outcomes (transurethral prostatectomy [TURP] and laser prostate ablation [KTPLAP]) in catheter-dependent men who were advised that they were not surgical candidates by their prior urologists, but subsequently underwent surgery at our institution. METHODS This is a retrospective observational study of catheter-dependent men (due to urinary retention) thought to be unsuitable for surgery. Exclusion criteria were neurogenic bladder and temporary catheterization. All patients underwent routine assessment including cystoscopy and videourodynamics. They were divided into 3 groups: detrusor underactivity (DU: bladder contractility index < 100), bladder outlet obstruction (BOO: no DU and BOO index > 40), and detrusor acontractility (DA). All men were counseled about TURP or KTPLAP as empiric treatment. The primary outcome measures were the Patient Global Impression of Improvement (PGII) ≤ 3 and catheter independence. Secondary outcomes were uroflow (Qmax) and post void residual urine (PVR). Mann-Whitney and Pearson chi-squared tests were utilized. RESULTS 92 catheter-dependent men were identified and 28 excluded. 40 elected surgery and 24 declined. Mean follow up was 25 months (median 20 months; range 1 month-11 years). There was no difference in any preoperative characteristic between men who underwent surgery and those who declined (table 1). Urodynamic and surgical outcomes are seen in table 2. Two of three patients who failed surgery had DA. CONCLUSIONS In this series, catheter-dependent men, thought to be poor surgical candidates, had a high success rate after prostate surgery despite three-fourths having detrusor underactivity. The role of DU as a prognostic factor for prostate surgery should be reevaluated. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e972-e973 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Christine Liaw More articles by this author Lucas Policastro More articles by this author Jerry Blaivas More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...