Urinary Retention In Patients Research Articles

Effect of Low-Frequency Pulsed Electrotherapy Combined with Acupoint Nursing on Postpartum Urinary Retention in Patients with Vaginal Delivery.

This study was carried out to investigate the effect of low-frequency pulsed electrotherapy combined with acupoint massage on postpartum urinary retention (PUR). The patients were divided into control group, intervention group 1, and intervention group 2 according to the nursing method. The control group received conventional postpartum care, intervention group 1 received conventional postpartum care and low frequency pulsed electrotherapy, and intervention group 2 received conventional postpartum care, low-frequency pulsed electrotherapy, and Shuidao point massage. The bladder function, comfort score, and quality of life score before and after intervention were compared among the three groups. The bladder function, comfort level, and quality of life of intervention group 1 and intervention group 2 after nursing were significantly better than those of the control group. In addition, intervention group 2 had better bladder function than intervention group 1, with lower residual urine volume and higher bladder compliance. In the Kolcaba score, the mental dimension of intervention group 2 was significantly higher than that of intervention group 1. In terms of QOL scores, the social function, physical function, and state of material life scores of intervention group 2 were significantly higher than those of intervention group 1. Low-frequency pulsed electrotherapy combined with acupoint massage can significantly improve the bladder function, comfort, and quality of life of patients with PUR.

Study on the Application Effect of Flexible Nursing Care in Patients with Postpartum Urinary Retention and its Effect on Lactation

Objective: To study the application effect of flexible nursing in patients with postpartum urinary retention and its effect on lactation. Methods: A total of 200 cases of postpartum urinary retention patients admitted between January 2021 and January 2022 were selected and randomly grouped into two groups, a control group (conventional nursing) and an observation group (flexible nursing), of 100 cases each. The time of onset of lactation, the lactation volume score, urinary indicators, the amount of post-partum hemorrhage, and the quality of life score of the two groups were compared. Results: The observation group’s lactation initiation time (21.41 ± 1.52) h and lactation volume score (2.11 ± 0.52) were better than that of the control group (P < 0.05). The observation group’s first urination time (2.11 ± 0.51) min was lower than the control group, while the urinary retention completely relieved time (33.12 ± 8.61) h, and first urinary volume (262.17 ± 52.41) mL was higher than that of the control group (P < 0.05). The amount of postpartum hemorrhage in the observation group (151.21 ± 22.12) mL was less than that in the control group (P < 0.05). The scores of somatic functioning (86.25 ± 2.20), psychological functioning (91.56 ± 1.45), social functioning (89.25 ± 2.45), and material life (89.75 ± 1.45) of the observation group were higher than those of the control group after nursing (P < 0.05). Conclusion: Flexible nursing care in patients with postpartum urinary retention exhibited significant nursing effects and lactation function was effectively improved.

Prevalence and Risk Factors of Urinary Retention in Patients With Cervical Cancer: A Meta-analysis and Systematic Review.

The literature is inconsistent on the prevalence and risk factors of urinary retention in patients with cervical cancer. The aim of this study was to review the literature on the prevalence of urinary retention in patients with cervical cancer and consolidate the risk factors. For this meta-analysis, eligible articles published in English or Chinese by December 10, 2021, were systematically searched for and retrieved from PubMed, Cochrane Library, Ovid-Embase Medline, Web of Science, PsycINFO, CINAHL, and Scopus. Prevalence, odds ratios (ORs), and 95% confidence intervals (CIs) were used for meta-analysis. Twenty-five studies were included in the analysis. The pooled overall prevalence was 0.26 (95% CI, 0.21-0.30, I2 = 95.0%). The identified risk factors were age (OR, 1.13; 95% CI, 1.08-1.19), urinary tract infection (UTI) (OR, 3.33; 95% CI, 1.48-7.49), surgical extent (OR, 2.95; 95% CI, 1.27-6.85), and catheter indwelling time (OR, 3.44; 95% CI, 2.43-3.87). The prevalence of urinary retention in patients with cervical cancer is 0.26. Older age, UTI, longer catheter indwelling time, and a larger surgical extent may increase the risk of urinary retention. Clinicians should identify patients at risk and adopt interventions such as individualized catheter care. Nursing staff should assess the risk of urinary retention in a patient with cervical cancer according to her age, presence of UTI, surgical extent, and catheterization time. A carefully chosen surgical procedure and interventions such as individualized education, timely catheter removal, treatment of UTI, and rehabilitation should be offered.

Perioperative pain management in thoracic surgery and side effects in the early postoperative period

Aim. To study the impact of various methods of perioperative pain management on the frequency of postoperative complications in patients with lung cancer after thoracotomy. Materials and methods. The study involved 157 patients who were divided into 4 groups. Multimodal analgesia (MA) group: according to the concept of preemptive analgesia, patients received 1000 mg paracetamol IV 1 hour before surgery and 50 mg dexketoprofen IV; in the postoperative period, dexketoprofen and paracetamol were administered every 8 hours as well as epidural analgesia: 40 mg of 2 % lidocaine solution after a catheter was placed and continuous ropivacaine infusion at a dose of 2 mg/ml (6–14 ml/h) in the postoperative period. Thoracic epidural analgesia (TEA) group: epidural analgesia: administration of 40 mg of 2 % lidocaine solution after catheter placement, continuous ropivacaine infusion in the postoperative period at a dose of 2 mg/ml (6–14 ml/h). Preemptive analgesia (PA) group: according to the concept of preemptive analgesia – 1000 mg IV paracetamol 1 hour before surgery as well as 50 mg IV dexketoprofen; in the postoperative period, dexketoprofen and paracetamol were administered every 8 hours. Control group (C): patients received 50 mg IV dexketoprofen for postoperative analgesia. If the severity of the pain syndrome was more than 50 mm according to the visual analogue scale (VAS), patients of all groups were given 10 mg IV morphine. The study involved the registration of side effects in the postoperative period. Results. Among 157 patients, complications in the postoperative period were observed in 61 patients (38.85 %). The frequency of complications in MA group was 10.8 % of the total number of patients, in TEA group – 12.7 %, PA – 6.4 %, and in C group – 8.9 %. The most common complaint among TEA group patients was injection-site itching (13.5 %). PA group patients had a significantly lower number of complications compared to TEA group (p = 0.035). There was no statistically significant difference in the frequency of nausea or urinary retention in patients of all groups (p > 0.05). No difference was noted in the number of pulmonary complications depending on the method of perioperative analgesia (p > 0.05). 31 patients (75.6 %) of PA group did not have any complications, that was significantly different from TEA (p = 0.021) and MA (p = 0.039) patient groups. Conclusions. The use of paracetamol and dexketoprofen combination in the perioperative period allows to reduce (p = 0.035) the total number of postoperative anesthetic complications compared to the use of only thoracic epidural analgesia. The use of a multimodal approach combining epidural analgesia and administration of paracetamol and dexketoprofen does not reduce (p > 0.05) the overall frequency of complications compared to patients without epidural analgesia.

Could plain pelvic X-rays be used as a screen for urinary retention in patients admitted with a hip fracture?

Could plain pelvic X-rays be used as a screen for urinary retention in patients admitted with a hip fracture?

Prostatic urethral lift for subjects in urinary retention (PULSAR): 12-Month results of a prospective controlled trial compared with real-world outcomes.

To examine the safety and efficacy of prostatic urethral lift (PUL) in acute urinary retention (AUR) patients within a controlled (PULSAR) and real-world setting (Real-World Retrospective study). PULSAR was a 12-month prospective study of PUL in AUR patients (n = 51) performed at six centres in the United Kingdom; enrolled BPH patients aged ≥50 years, with prostate volume of ≤100 cc. AUR was defined as being catheter dependent with at least one prior failed trial without catheter (TWOC) while on an alpha-blocker. RWR consisted of 3226 consecutive PUL patients across 22 international sites treated between July 2017 and March 2020; 469 of whom were in urinary retention (RWRr), that is, catheter-dependent at the time of their procedure. Symptom response, uroflow and catheter independence rates were compared between PULSAR and RWRr subjects. A logistical regression model was constructed to evaluate patient baseline and dynamic factors predicting success after the procedure. Seventy-three percent of PULSAR subjects were catheter independent and free from surgical reintervention at 12 months post-PUL. Success was associated with higher voiding efficiency during the perioperative period. Slightly higher catheter-independent rates (80%) were seen in RWRr patients; variables that influenced success included age <70 years, lower baseline prostate-specific antigen (PSA), lower baseline post-void residual (PVR) and shorter pre-procedural catheter duration. Logistic regression of the combined PULSAR and RWRr retention groups revealed that procedural age <70 years and higher bladder voiding efficiency (BVE) were associated with success. Lower baseline PSA and PVR, younger age and shorter pre-procedure catheter durations drove successful outcomes in AUR patients undergoing PUL. Post-PUL voiding efficiencies may help ascertain long-term response to treatment.

Pengaruh Pemakaian Lidocaine Terhadap Tingkat Nyeri Pasien Retensi Urin Saat Pemasangan Kateter

Pain is an uncomfortable and highly individualized feeling that others cannot feel. Lidocaine is a drug to relieve pain or has a numbing effect on the body. This study aims to determine the effect of lidocaine use on the pain level of urinary retention patients during catheter insertion in the emergency room of Dr Haryoto Lumajang Hospital. The research design used quasi-experiments with Two Group Post-test design. Accidental sampling was used to determine the number of samples and obtained 30 respondents, every 15 people in the intervention group and control group. The pain was measured using the NRS (Numeric Rating Scale) pain scale. The intervention group was given lidocaine 2% as much as one ampoule mixed with lubricant inserted into the urethra using a syringe. The control group only used lubricant. Statistical tests using the Mann-Whitney U Test. In the intervention group, 11 (73.3%) respondents experienced mild pain, and 4 (26.7%) respondents felt moderate pain. In the control group, 14 (93.3%) respondents experienced moderate pain and 1 (6.7%) respondent felt severe pain. Statistical test with a p-value of 0.000 means that lidocaine use has an effect on the pain level of patients with urine retention during catheter insertion. Taking into account the findings of this study, nursing can play a role in improving patient experience and providing better care during catheter insertion in patients with urine retention.

Research progress of moxibustion for postoperative urinary retention in patients with hip fracture

Research progress of moxibustion for postoperative urinary retention in patients with hip fracture

MP72-09 SELF-SCHEDULING IMPROVES QUALITY OF CARE FOR HOSPITAL DISCHARGE FOLLOW UP OF URINARY RETENTION PATIENTS

You have accessJournal of UrologyCME1 Apr 2023MP72-09 SELF-SCHEDULING IMPROVES QUALITY OF CARE FOR HOSPITAL DISCHARGE FOLLOW UP OF URINARY RETENTION PATIENTS Avi Baskin, Matthew Chou, Thomas Chi, and Michelle Van Kuiken Avi BaskinAvi Baskin More articles by this author , Matthew ChouMatthew Chou More articles by this author , Thomas ChiThomas Chi More articles by this author , and Michelle Van KuikenMichelle Van Kuiken More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003340.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Delays in patient care after discharge from the hospital can lead to poor quality care and outcomes. At UCSF, one source of patient discontinuity of care has been the inability to consistently obtain an expedited follow up appointment in the urology outpatient clinic after hospital discharge when patients had a new foley placed during their hospital stay. This quality improvement project sought to improve the process for these patients. METHODS: To understand barriers to prompt follow up for patients discharging from UCSF, we employed LEAN A3 methodology. A total of 2 PDSA cycles were completed with two total interventions implemented. The first intervention was to create standing appointments with advanced practice providers that were reserved in the urology clinic for these discharge referrals. The second intervention was the creation of a novel patient self-scheduling approach using the existing electronic medical record. Patients who need referral for a voiding trial with urology were identified by their primary team and a new discharge order was placed. Placement of the referral order generated a ticket in the patient’s portal, allowing patients to select a date and time for their follow up voiding trial. RESULTS: Prior to intervention, there was a median time of 2.0 days from referral placement to appointment scheduling and 9.5 days between referral placement and appointment date. (Figure 1) 20% of patients with referrals were lost to follow up. After the intervention, patients where were scheduled via the self-scheduling work flow had a median of 1.5 days from referral to scheduled appointment compared to 5.5 days from the prior work flow. The post intervention median time between referral placement and appointment scheduling was 8.0 days. 5% of patients in the post intervention period were lost to follow up. CONCLUSIONS: Automation and infrastructure enhancement improved the quality of care and shorted time to follow up for patients who had foley catheters placed during their hospital stay. Efforts like this can be scaled to improve urological quality of care and transitions in care. Source of Funding: none © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e1027 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Avi Baskin More articles by this author Matthew Chou More articles by this author Thomas Chi More articles by this author Michelle Van Kuiken More articles by this author Expand All Advertisement PDF downloadLoading ...

Prophylactically Given Tamsulosin in Preventing Postop Urinary Retention in Surgery Under Spinal Anaesthesia

Aim: To determine effect of tamsulosin in the prevention of post operative urinary retention in patients undergoing spinal anesthesia Study design: Randomized control trial Place and duration of study: Urology Department, Mayo Hospital, KEMU, Lahore February 2020- February 2021 Methodology: Only 106 patients (53 individuals in each group) were included in the study with non probability purposive sampling. The patients undergoing surgery under spinal anaesthesia were either given tamsulosin in one group and not given tamsulosin in other group. Postoperatively patients were monitored for urinary retention. SPSS-26 was used for analyzing the data. Result: Incidence of postoperative urinary retention was significantly higher in placebo group as compared to Tamsulosin group. i.e. (overall result of 26.42 vs 3.77%, p-value=0.001 and 26% vs 2.5% in hernia group and 33.3 vs 7.7 % in hydrocele group) Conclusion: Prophylactically given tamsulosin helps in preventing postoperative urinary retention in patients undergoing surgery under spinal anaesthesia. Keywords: Postoperative urinary retention, Tamsulosin, Spinal Anaesthesia

Urine Residual Volume in Normal Dogs Determined by Direct Measurement and Comparison to Two-Dimensional Ultrasonographic Measurement.

Normal urine residual volume (URV) in dogs has not previously been established by direct measurement. Twenty-two client-owned normal healthy dogs (8 female spayed, 12 male castrated, 2 male intact) without history of urinary abnormalities were included. Dogs were walked outside for 5 min to allow for natural voiding, immediately followed by urinary bladder ultrasound and urinary catheterization. The URV was recorded, and the ultrasound images were used to estimate URV for each dog. There was no significant difference between male and female URV; therefore, all data were pooled. With a 90% confidence interval, URV was 0-0.47 mL/kg with a mean URV of 0.21 mL/kg and a median value of 0.175 mL/kg. There was no significant difference between the measured URV and the ultrasound-determined URV. This case series supports previously established normal URV in the dog; however, a reference interval based on a larger population of dogs with further evaluation of body size/weight, sex, and neuter status is recommended to be established for use in clinical setting to differentiate normal urination from urinary retention in patients.

Risk factors for postoperative urinary retention in patients undergoing colorectal surgery: a systematic review and meta-analysis.

Postoperative urinary retention (POUR) is a common complication following colorectal surgery. The incidence of POUR among colorectal surgery patients varies widely, and the risk factors and outcomes of POUR are also debatable. This meta-analysis aims to systematically evaluate the risk factors for POUR in patients after colorectal surgery. PubMed, Web of Science, the Cochrane Library, Embase, Medline, and Chinese databases (CBM, CNKI, and WanFang Databases) were searched to identify relevant cohort studies (from inception to August 2022). Two researchers independently conducted literature quality evaluation and data extraction. All data were analyzed by using the Review Manager 5.4 software. Nineteen studies with 101,025 patients were included in this meta-analysis. The risk factors for POUR in colorectal surgery patients were male sex, older age, diabetes mellitus, urological diseases, tumor location in the lower rectum, APR, laparoscopic surgery, operation time ≥ 4h, postoperative date of urinary catheter removal, excessive intraoperative intravenous fluid volume, and postoperative ileus. The postoperative anastomotic leak, on the other hand, was not a risk factor for POUR. Multiple risk factors influence the incidence of POUR in patients undergoing colorectal surgery. To reduce the incidence of POUR in colorectal surgery patients, medical staff should identify risk factors early and enforce interventions to prevent them.

Factors associated with postoperative urinary retention in patients undergoing penile prosthesis implantation.

Placement of penile prosthesis had been well described in the outpatient setting, however, one barrier to same-day discharge is postoperative urinary retention (POUR). POUR remains a condition encountered during ambulatory surgical procedures and has yet to be characterized in patients undergoing penile prosthesis. We characterized POUR in a cohort of penile prosthesis recipients along with risk factors and management. Patients undergoing penile prosthesis implantation from 2014 through 2020 without pre-existing retention were included. All patients underwent a void trial immediately following penile prosthesis in the post-anesthesia care unit. POUR was strictly defined as (1) any patient requiring catheter replacement after prosthesis, (2) a rising post-void residual, or (3) inability to void after 6 h regardless of whether a catheter was placed. Independent procedures, demographic, intraoperative, and postoperative risk factors for POUR were assessed. 317 men were included of whom 27.1% experienced POUR. Men experiencing POUR and those not in retention were essentially indistinguishable with respect to previously described risk factors for POUR. Only use of both α-blockers and 5-α-reductase inhibitors was significantly associated with a greater risk of POUR, a finding maintained on adjusted analysis (adjusted odds ratio 10.1, 95% confidence interval 2.1 to 49.8). POUR resolved without intervention in 3.5%, a single episode of clean intermittent catheterization (CIC) in 7.0% of patients, and repeated CIC or indwelling catheter placement with a successful delayed void trial in 88.4% of patients. Rate of prosthesis infection in patients who experienced POUR did not significantly differ from those who did not experience POUR (4.7% vs. 2.2% p = 0.26). Our findings suggest that POUR is experienced in as many as 1 in 4 men undergoing penile prosthesis placement, most of whom must be managed with indwelling catheterization or repeated CIC. Those with indicators of symptomatic prostate enlargement are at significantly greater risk of urinary retention.

Does tamsulosin decrease postoperative urinary retention in spine surgery? A double-blind, randomized controlled trial.

The authors' objective was to determine whether preoperative administration of tamsulosin decreases postoperative urinary retention after spine surgery. In this randomized, double-blind, placebo-controlled clinical trial performed at a single institution between 2016 and 2019, eligible males aged 50 to 85 years were administered tamsulosin or placebo for 5 days prior to elective spine surgery. Patients were excluded if they were taking alpha adrenergic blocking drugs; were allergic to tamsulosin, lactose, or sulfa drugs; had a preexisting indwelling urinary catheter, orthostatic hypotension, history of urological surgery, or renal failure; or were scheduled for cataract surgery within 2 weeks. Screening identified 1051 eligible patients (140 declined participation, 150 did not meet the inclusion criteria, and 151 did not enroll for other reasons). A total of 610 patients were randomly assigned to receive 0.4 mg oral tamsulosin or an identical placebo capsule for 5 days preoperatively and 2 days postoperatively. A total of 497 patients were included in the final statistical analysis. The overall rate of postoperative urinary retention was 9.7%, and tamsulosin had no observed effect on reducing the rate of postoperative urinary retention as compared with placebo (9.4% vs 9.9%, p = 0.96). There were no significant differences in the reported adverse events between groups. Multivariate logistic regression was performed to model the effects of patient, surgical, and anesthetic factors on postoperative urinary retention, and the study drug remained an insignificant factor. This study did not detect an effect of perioperative tamsulosin on reducing the rate of postoperative urinary retention in male patients aged 50 to 85 years who underwent elective spine surgery. This study does not support the routine use of tamsulosin to reduce postoperative urinary retention in patients without a previous prescription. It is unknown if subpopulations exist for which prophylactic tamsulosin may reduce postoperative urinary retention.

Are Formal Voiding Trials Necessary After Posterior Compartment Reconstructive Surgery?

Posterior compartment surgery is considered a risk factor for postoperative urinary retention because of the impact of postoperative pain on the pelvic floor; however, few studies have examined the association between posterior compartment reconstructive surgery and urinary retention. The aim of the study was to compare rates of urinary retention in patients undergoing vaginal reconstructive surgery, without hysterectomy, in the posterior compartment only versus any apical and/or anterior compartment (with or without posterior compartment). In this retrospective cohort study, we evaluated patients who underwent surgery, without hysterectomy, in the posterior compartment only versus any apical and/or anterior compartment (with or without posterior compartment) from January 2015 to November 2020. Our primary outcome was rate of postoperative urinary retention, defined as a failed voiding trial before discharge. Secondary outcome was days of catheterization. Multivariable logistic regression was performed to assess variables associated with a failed voiding trial. Of 362 patients, 141 (39.0%) underwent surgery in the posterior compartment only and 221 (61.0%) underwent vaginal apical and/or anterior compartment surgical procedures. Rate of retention was significantly lower in the posterior compartment only group (9.9% vs 41.6%, P < 0.001). The median numbers of days of catheterization were significantly fewer in the posterior compartment only group (0 [0,0] vs 0 [0,3], P < 0.001). In multivariable logistic regression, posterior compartment only surgery was associated with passing the voiding trial (odds ratio, 6.0; 95% confidence interval, 2.97-12.03). Rates of postoperative urinary retention after surgery in the posterior compartment are low, and these patients may not require formal voiding trials after surgery.

Predictive Value of Voiding Efficiency After Active Void Trial in Men Undergoing BPH Surgery

ObjectivesTo determine the predictive value of voiding efficiency on acute urinary retention after discharge from BPH surgery. Materials and methodsWe performed a prospective observational cohort study of three surgeons’ practices from 2019 to present. All men included underwent trial of void on post-operative day one after transurethral resection of prostate or Holmium enucleation of prostate . Active filling void trials were performed on all patients and voiding efficiency (percent of bladder volume emptied) was calculated. Multivariable logistic regression was performed to determine predictors of developing acute urinary retention. ResultsDuring the study period, 188 men met inclusion criteria. 110 (59%) men underwent Holmium enucleation of prostate , and 78 (41%) underwent transurethral resection of prostate. The median age of our cohort was 70 (IQR 65-75). The median prostate size was 100g (IQR 61-138g). Nineteen patients (10%) returned after discharge with acute urinary retention requiring catheterization. On post-operative day one, the median voiding efficiency was 75% (IQR 55%-94%). On multivariable analysis, patients with a voiding efficiency less than 50% were 3.8 times more likely (95% confidence interval 1.1-12.8) to develop subsequent retention compared to a voiding efficiency of greater than 75%. Increasing pre-operative prostate size was associated with lower risk of urinary retention after discharge (aOR 0.8, 95%CI 0.6-0.9). ConclusionsVoiding efficiency after an active void trial helps stratify risk of urinary retention in patients undergoing benign prostate surgery. High-risk patients include those with voiding efficiencies less than 50% and smaller pre-operative prostate sizes (<80g).

Long-Term Reduction of Bacterial Adhesion on Polyurethane by an Ultra-Thin Surface Modifier.

Indwelling urinary catheters are employed widely to relieve urinary retention in patients. A common side effect of the use of these catheters is the formation of urinary tract infections (UTIs), which can lead not only to severe medical complications, but even to death. A number of approaches have been used to attempt reduction in the rate of UTI development in catheterized patients, which include the application of antibiotics and modification of the device surface by coatings. Many of these coatings have not seen use on catheters in medical settings due to either the high cost of their implementation, their long-term stability, or their safety. In previous work, it has been established that the simple, stable, and easily applicable sterilization surface coating 2-(3-trichlorosilylpropyloxy)-ethyl hydroxide (MEG-OH) can be applied to polyurethane plastic, where it greatly reduces microbial fouling from a variety of species for a 1-day time period. In the present work, we establish that this coating is able to remain stable and provide a similarly large reduction in fouling against Escherichia coli and Staphylococcus aureus for time periods in an excess of 30 days. This non-specific coating functioned against both Gram-positive and Gram-negative bacteria, providing a log 1.1 to log 1.9 reduction, depending on the species and day. This stability and continued efficacy greatly suggest that MEG-OH may be capable of providing a solution to the UTI issue which occurs with urinary catheters.

Construction and Validation of a Risk Prediction Model for Postoperative Urinary Retention in Lung Cancer Patients.

Indwelling catheter is a routine procedure in surgical patients. Studies have shown that prolonged indwelling urinary catheterization increases the risk of postoperative urinary tract infection. Although early removal of the urinary catheter after operation can reduce the risk of postoperative urinary symptoms and tract infections, it may lead to postoperative anesthetic dysuria. Therefore, this study investigates the urinary retention and related risk factors in patients after thoracoscopic lobectomy under general anesthesia. The clinical data of 214 patients who underwent thoracoscopic lobectomy in the Department of Thoracic Surgery of a tertiary class A cancer hospital in Beijing from July 2020 to April 2021 were collected. A risk prediction model was established by logistic regression analysis, and the prediction effect was determined using the area under the receiver operating characteristic (ROC) curve. The incidence of indwelling catheter after thoracoscopic lobectomy was 44.8% (96/214). Sex (OR = 21.102, 95% CI: 2.906–153.239, P=0.003), perception of shame (OR = 74.256, 95% CI: 6.171–893.475, P=0.001), age (OR = 1.095, 95% CI: 1.014–1.182, P=0.021), and bed rest time (OR = 1.598, 95% CI: 1.263–2.023, P < 0.021) were the factors influencing urinary retention after thoracoscopic lobectomy. This model can effectively predict the occurrence of postoperative urinary retention in patients with lung cancer and help medical staff to intervene effectively before the onset of urinary retention, which provides reference for preventive treatment and nursing intervention.

Prostate arterial chemoembolization for treatment of refractory hematuria and urinary retention in patients with localized advanced prostate cancer.

To evaluate the safety and efficacy transcatheter arterial chemoembolization (TACE) for the treatment of refractory gross hematuria (RGH) and urinary retention (UR) secondary to localized advanced prostate cancer (PCa). Thirty-two patients (mean age 72.5 years, range 60-89) with advanced PCa-related RGH that failed conventional therapy were included. Twenty-two of these patients had catheter-dependent due to PCa-related UR. TACE was performed with epirubicin (EPI)-eluting HepaSpheres (HS) plus intra-arterial (IA) infusion of docetaxel. Technical success, adverse events (AEs), overall survival (OS), control of RGH, removal of indwelling catheters, and local disease control, were evaluated. Technical success was achieved in 100% without major AEs. Mean follow up post-TACE was 27 months (range 8-56 months) with a mean OS of 30 months. GRH stopped within 5 days after TACE in all patients, 26 (86.7%) of these patients exhibited good bleeding control during a mean follow-up of 24 months; 17 (77.3%) of the 22 patients with UR had recovered spontaneous urination, 15 (88.2%) patients were catheter-free at their last follow-up with a mean of 24 months. BS was obtained in 73.3% (22/30) of patients at a mean follow-up of 29 months. At the last visit, 22 patients had a mean of 36 months follow-up and the mean percentage reduction in prostate volume was 55.5%, with a statistically different from baseline (P = 0.022). Negative biopsy results were obtained in 84.2% (16/19) of the patients at 12-47 months after TACE. Compared with baseline values, there was a significant improvements in IPSS, QoL, Qmax, and PVR (all P < 0.05). TACE using EPI-eluting HS plus IA infusion of docetaxel is a safe and effective treatment option for the advanced PCa patients with GRH and UR, and it could be considered as an alternative if there was no other therapeutic choice.

Emerging outcomes of water vapor thermal therapy (Rezum) in a broad range of patients with lower urinary tract symptoms secondary to benign prostatic hyperplasia: A systematic review.

Water vapor thermal therapy (Rezum) is a novel, minimally invasive surgical technology used to treat lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH). The objective of this systematic review is to evaluate the latest efficacy and safety profile of Rezum in patients with LUTS secondary to BPH. PubMed/MEDLINE and the Cochrane Library databases were systematically searched, in accordance with the PRISMA statement, for relevant articles in the English language till 1 August 2021. Randomized and nonrandomized studies that evaluated urinary outcomes and/or adverse events were deemed eligible. Nineteen studies (N=1942), published in 25 articles, were included. International Prostate Symptom Score (IPSS), quality of life (QoL), and maximum urinary flow rate (Qmax) significantly improved as early as 1 month postoperatively and remained durable for up to 5 years. Significant median percent improvements in IPSS, QoL, and Qmax at 3 months were 51%, 51%, and 66%, respectively. Patients with obstructive median lobes, large prostates (>80 g), small prostates (<30 g), and urinary retention also experienced significant relief in LUTS, with 83% of urinary retention patients becoming catheter independent at a median of 14 days. Most adverse events were transient and nonserious and occurred in 0% to 76% of patients (median 29%), with de novo erectile dysfunction rates ranging between 0% and 3.1%. Surgical retreatment rate ranged between 4.4% and 7.5% at 5 years postoperatively. Rezum provides durable improvements in symptoms, irrespective of prostate volume and urinary retention status, and has low rates of sexual dysfunction.