Korean J Androl.  2011 Aug;29(2):168-173. 10.5534/kja.2011.29.2.168.

Factors Causing Acute Urinary Retention after Transurethral Resection of the Prostate in Patients with Benign Prostate Hyperplasia

• Yang SJ
• Ji YS
• Song PH
• Kim HT
• Moon KH

• KMID: 2226471
• DOI: http://doi.org/10.5534/kja.2011.29.2.168

Abstract

PURPOSE
Urologists occasionally experience some cases of voiding failure after transurethral resection of prostate (TURP). Preoperative and postoperative factors attributable to acute urine retention (AUR) after catheter removal in post-TURP patients were evaluated and analyzed to determine the causative factors for AUR.
MATERIALS AND METHODS
From June 2004 to May 2008, a total of 172 patients who underwent TURP due to symptomatic benign prostatic hyperplasia (BPH) were divided into the AUR group (n=21) and the control group (n=151). The AUR group was defined as patients with voiding difficulty within 24 hours and whose residual urine volume was above 400 ml after catheter removal. The control group was defined as patients without AUR. Age, duration of symptoms, International prostate symptom score (IPSS), Quality of life score (QoL), uroflowmetry, post-void residual urine volume, preoperative serum prostate specific antigen (PSA) level, preoperative prostate volume, resected prostate volume, rate of prostate resection [resected prostate volume/preoperative prostate volume x 100], operative time and duration of catheter were retrospectively analyzed to identify which of these were the factors related with AUR after catheter removal in post-TURP patients.
RESULTS
Preoperative prostate volume was higher (90.7+/-50.4 vs 64.4+/-32.7, p=0.002) and rate of prostate resection was lower (38.8+/-8.1 vs 50.5+/-12.4, p<0.001) in AUR group compared to control group. And age, duration of symptoms, IPSS, QoL, uroflowmetry, post-void residual urine volume, preoperative serum PSA level, resected prostate volume, operative time and duration of catheter were not statistically significant in both groups. The multivariate analysis subsequently showed that preoperative prostate volume (p=0.010, OR=1.040) and rate of prostate resection (p=0.001, OR=0.901) were independent factors related with AUR after catheter removal in post-TURP patients.
CONCLUSIONS
The incidence of AUR after catheter removal was higher in post-TURP patients with high preoperative prostate volume and low rate of prostate resection. Therefore the surgeon's effort to increase the rate of prostate resection, especially in patients with large prostate volume, may lower the incidence of postoperative AUR.

Keyword

Transurethral resection of prostate; Urinary retention; Benign prostatic hyperplasia

MeSH Terms

Catheters
Humans
Hyperplasia
Incidence
Multivariate Analysis
Operative Time
Prostate
Prostate-Specific Antigen
Prostatic Hyperplasia
Quality of Life
Retention (Psychology)
Retrospective Studies
Transurethral Resection of Prostate
Urinary Retention
Prostate-Specific Antigen

Figure

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  Fig. 1. Comparison of preoperative prostate volume between acute urine retention (AUR) and control group. Bars are mean±standard error of mean (∗Statistical significance was evaluated by Multiple logistic regression analysis, p＜0.05).

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  Fig. 2. Comparison of rate of resected volume to prostatic volume between acute urine retention (AUR) and control group. Bars are mean±standard error of mean (∗Statistical significance was evaluated by Multiple logistic regression analysis, p＜0.05).

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