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首页> 外文期刊>BJU international >A prospective study of conservatively managed acute urinary retention: prostate size matters.
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A prospective study of conservatively managed acute urinary retention: prostate size matters.

机译：保守管理的急性尿retention留的前瞻性研究：前列腺大小很重要。

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OBJECTIVE: To evaluate in a prospective study the medium- to long-term outcome of a policy of conservatively managing acute urinary retention (AUR), arising solely by bladder outlet obstruction caused by benign prostatic enlargement (BPE), and to identify the factors favouring a positive outcome of a trial without catheter (TWOC). PATIENTS AND METHODS: All men admitted as an emergency with primary AUR caused by BPE (from August 1997 to March 2000) underwent a TWOC. The following variables were recorded; the nature and duration of any preceding lower urinary tract symptoms, previous episodes of retention, concomitant anticholinergic medication, coexisting constipation, alcohol as a precipitating cause of AUR, previous prostatectomy, confirmed urinary tract infection, residual urine drained on catheterization and prostate size, as determined by a digital rectal examination (DRE) carried out by one consultant urologist in all patients. Those voiding successfully were followed up prospectively using the International Prostate Symptom Score (IPSS), quality-of-life score, urinary flow rate measurement and ultrasonographic measurement of the postvoid residual (PVR). RESULTS: Of the 40 men with AUR, 22 (55%) voided spontaneously after removing the catheter and continued to do so with mean peak flow rates of 12.2 mL/s and mean PVRs of 69.6 mL over a follow-up of 8-24 months. These patients remained asymptomatic, with a mean IPSS of 5.2 and quality-of-life score of 0.9. These men had a mean prostatic size of 15.9 g and a mean catheterized residual volume of 814 mL, while in those who had an unsuccessful TWOC the mean prostate size was 27.5 g (P = 0.006) and a mean catheterized residual volume of 1062 mL (P = 0.09). Prostate size as assessed by the DRE was the most significant factor in predicting the outcome of a TWOC. CONCLUSION: A TWOC is justified in the long-term for men presenting with AUR caused by BPE. Prostate size is the most important factor for predicting the outcome of such a trial.
机译：目的：在一项前瞻性研究中，评估仅由良性前列腺肿大（BPE）引起的膀胱出口梗阻引起的保守管理急性尿retention留（AUR）政策的中长期效果，并找出有利于患者的因素无导管试验（TWOC）的积极结果。患者和方法：所有因BPE（1997年8月至2000年3月）因原发性AUR入院的男性患者均接受了TWOC。记录了以下变量;先前出现的下尿路症状的性质和持续时间，先前的retention留发作，伴随的抗胆碱能药物，便秘并存，酒精是引起AUR的主要原因，先前的前列腺切除术，确诊的尿路感染，经导管插入术排出的残留尿液和前列腺大小由一名顾问泌尿科医师对所有患者进行的数字直肠检查（DRE）确定。使用国际前列腺症状评分（IPSS），生活质量评分，尿流率测量和术后残留残余的超声检查（PVR），对成功排空的患者进行前瞻性随访。结果：40例AUR患者中，有22例（55％）拔出导管后自发排尿，并继续这样做，在8-24例随访中，平均峰值流速为12.2 mL / s，平均PVR为69.6 mL个月。这些患者无症状，平均IPSS为5.2，生活质量评分为0.9。这些男性的平均前列腺大小为15.9 g，平均导管剩余量为814 mL，而在那些未成功TWOC的患者中，平均前列腺大小为27.5 g（P = 0.006），平均导管剩余量为1062 mL（ P = 0.09）。 DRE评估的前列腺大小是预测TWOC结果的最重要因素。结论：从长远来看，TWOC对于由BPE引起AUR的男性是合理的。前列腺大小是预测此类试验结果的最重要因素。

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