Early Versus late Catheter Removal in Patients with Urinary Retention Secondary to Benign Prostatic Hyperplasia under Tamsulosin Treatment

Abstract

SUMMARY A cute urinary retention (AUR) is a severe complication of BPH characterized by a sudden and painful inability to void voluntarily (Emberton, 1999). Management of AUR consists of immediate bladder decompression by catheterization usually followed by BPH-related surgery. The evidence that emergency surgery was associated with an increased mortality rate at 30 days and a higher rate of postoperative complications, and the potential morbidity associated with prolonged catheterization have led to an increasing use of a trial without catheter (TWOC) (McNeill, 2006). Shim et al. (2006) have suggested that the post-AUR use of α1-blockers before a TWOC prevents the recurrence of AUR and increases the success rate of self-voiding. Currently, there is no consensus on the optimal management of AUR in terms of type of catheterization, duration of catheterization and management following catheterization. The optimum duration of treatment with α1 blockers has not been fully assessed, and there is controversy about the length of time the catheter should remain in situ for the initial treatment phase (Fitzpatrick et al., 2011). Several studies were done to compare the impact of duration of catheterization, as regarding the success of TWOC many studies showed that prolonged catheterization enhances success rate while other studies showed that there was no difference between early versus late catheter removal in enhancing success rate of TWOC. As regarding complications of catheterization such as UTI, hematuria, catheter leakage and blockage, there is a consensus among several studies that prolonged catheterization significantly increases prevalence of catheter related complications.