scholarly journals A Prospective Pilot Study to Validate the Management Protocol for Patients Presenting with Acute Urinary Retention: A Community-Based, Nonhospitalised Protocol

2006 ◽  
Vol 6 ◽  
pp. 2436-2441 ◽  
Author(s):  
Shyamala S. Gopi ◽  
Chris M. Goodman ◽  
Allison Robertson ◽  
Derek J. Byrne
Keyword(s):  
Emergency Department ◽  
Urinary Retention ◽  
Flow Rate ◽  
Acute Urinary Retention ◽  
Peak Flow ◽  
Successful Implementation ◽  
Residual Volume ◽  
Peak Flow Rate ◽  
Male Patients ◽  
Trial Without Catheter

Acute urinary retention (AUR) in males is managed conventionally by hospital admission, alpha-adrenergic therapy, and trial without catheter. To reduce inpatient bed pressures, we set up a protocol to manage such patients in the community. We review our results in this paper. We performed a prospective study of male patients presenting to our acute admissions ward and Accident and Emergency department over 6 months. Patients with chronic urinary retention, macroscopic haematuria, sepsis, urinary tract infection, and/or serum creatinine >130 mmol/l were excluded from the study. Those enrolled were catheterised, commenced on alfuzosin (10 mg nocte), and discharged to the community. A trial without catheter (TWOC) was performed 5—7 days later. QoL/IPSS, peak flow rate, and residual volume assessment were performed following successful TWOC 3 months later.Thirty-one male patients with a median age of 69 years were studied and the median residual volume following catheterisation was 900 ml. The aetiology of AUR was benign prostatic hyperplasia (BPH) in 29 patients and constipation in the remaining 2 patients. TWOC was successful in 19 patients (61.3%) following first TWOC, 26 (83.9%) following second trial of voiding. The mean peak flow rate was 6.5 ml/sec and postvoid scan 165 ml, following an immediate TWOC. At 3 months follow-up, mean peak flow rate was 13.2 ml/sec, postvoid scan 26.5 ml, IPSS 4.5, and QoL score was 2. This study has shown that AUR can be managed safely and effectively in the community. Effective communication with the nurse urology specialist, general practitioner, and emergency department are crucial for the successful implementation of the protocol.

Peak flow rate is the best predictor of acute urinary retention following low-dose-rate brachytherapy

Brachytherapy ◽  
2009 ◽  
Vol 8 (2) ◽  
pp. 162-163
Author(s):  
Tetsuhiro Ikeda ◽  
Katsuto Shinohara ◽  
Barby Pickett ◽  
Jocelyn Speight ◽  
Alexander Gottschalk ◽  
...  
Keyword(s):  
Dose Rate ◽  
Urinary Retention ◽  
Flow Rate ◽  
Acute Urinary Retention ◽  
Low Dose ◽  
Peak Flow ◽  
Peak Flow Rate ◽  
Low Dose Rate ◽  
Low Dose Rate Brachytherapy

1366: Influence of Age on Outcome of Trial Without Catheter (TWOC) During Alfuzosin 10 MG OD Therapy in Patients With Acute Urinary Retention (AUR) Related to BPH

2004 ◽  
Vol 171 (4S) ◽  
pp. 360-360 ◽  
Author(s):  
Claus G. Roehrborn ◽  
Timothy B. Hargreave ◽  
Alan S. McNeill ◽  
Amy Naadimuthu ◽  
Jean-Luc Beffy
Keyword(s):  
Urinary Retention ◽  
Acute Urinary Retention ◽  
Trial Without Catheter

scholarly journals Correlation of intravesical prostatic protrusion with severity of lower urinary symptoms among patients with benign prostatic hyperplasia

2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Babatunde K. Hamza ◽  
Muhammed Ahmed ◽  
Ahmad Bello ◽  
Musliu Adetola Tolani ◽  
Mudi Awaisu ◽  
...  
Keyword(s):  
Flow Rate ◽  
Bladder Outlet Obstruction ◽  
Peak Flow ◽  
Prostate Volume ◽  
Outlet Obstruction ◽  
Peak Flow Rate ◽  
The Mean ◽  
Benign Prostate ◽  
Intravesical Prostatic Protrusion ◽  
Lower Urinary

Abstract Background Benign prostate hyperplasia (BPH) is characterized by an increase in the number of epithelial and stromal cells in the periurethral area of the prostate. Lower urinary tract symptoms (LUTS) often develop as a manifestation of bladder outlet obstruction (BOO) due to benign prostate enlargement. When the prostate enlarges, protrusion into the bladder often occurs as a result of morphological changes of the gland. Prostatic protrusion into the bladder can be measured with ultrasound as intravesical prostatic protrusion (IPP). There are studies that have shown IPP as a reliable predictor of bladder obstruction index (BOOI) as measured by pressure flow studies. IPP is thereby reliable in assessing the severity of BOO in patients with BPH. The severity of symptoms in patients with BPH can be assessed through several scoring systems. The most widely used symptoms scoring system is the International Prostate Symptoms Score (IPSS). The aim of this study is to determine the correlation of IPP with IPSS in men with BPH at our facility. Methods The study was a cross-sectional observational study that was conducted at the Division of Urology, Department of Surgery, in our facility. The study was conducted on patients greater than 50 years LUTS and an enlarged prostate on digital rectal examination and/or ultrasound. All consenting patients were assessed with the International Prostate Symptoms Score (IPSS) questionnaire, following which an abdominal ultrasound was done to measure the intravesical prostatic protrusion (IPP), prostate volume (PV) and post-void residual (PVR) urine. All the patients had uroflowmetry, and the peak flow rate was determined. The data obtained were entered into a proforma. The results were analyzed using Statistical Package for Social Sciences (SPSS) software package version 20. Results A total of 167 patients were seen during the study period. The mean age was 63.7 ± 8.9 years, with a range of 45–90 years. The mean IPSS was 18.24 ± 6.93, with a range of 5–35. There were severe symptoms in 49.1%, while 43.1% had moderate symptoms and 7.8% had mild symptoms. The overall mean IPP was 10.3 ± 8 mm. Sixty-two patients (37.1%) had grade I IPP, 21 patients (12.6%) had grade II IPP and 84 patients (50.3%) had grade III IPP. The mean prostate volume and peak flow rate were 64 g ± 34.7 and 11.6 ml/s ± 5.4, respectively. The median PVR was 45 ml with a range of 0–400 ml. There was a significant positive correlation between the IPP and IPSS (P = 0.001). IPP also had a significant positive correlation with prostate volume and post-void residual and a significant negative correlation with the peak flow rate (P < 0.01). Conclusion Intravesical prostatic protrusion is a reliable predictor of severity of LUTS as measured by IPSS, and it also shows good correlation with other surrogates of bladder outlet obstruction.

Decreasing peak flow rate with a new bag-valve-mask device: effects on respiratory mechanics, and gas distribution in a bench model of an unprotected airway

Resuscitation ◽  
2003 ◽  
Vol 57 (2) ◽  
pp. 193-199 ◽  
Author(s):  
Horst G. Wagner-Berger ◽  
Volker Wenzel ◽  
Angelika Stallinger ◽  
Wolfgang G. Voelckel ◽  
Klaus Rheinberger ◽  
...  
Keyword(s):  
Flow Rate ◽  
Respiratory Mechanics ◽  
Peak Flow ◽  
Peak Flow Rate ◽  
Gas Distribution ◽  
Unprotected Airway ◽  
Bench Model

scholarly journals Factors Affecting Trial Without Catheter for First Spontaneous Acute Urinary Retention

2013 ◽  
Vol 17 (3) ◽  
pp. 121 ◽  
Author(s):  
Punit Mahadik ◽  
Surya Prakash Vaddi ◽  
Chandra-Mohan Godala ◽  
V. Vijaya Kumar Reddy ◽  
Sambar Venkat Krishna
Keyword(s):  
Urinary Retention ◽  
Acute Urinary Retention ◽  
Factors Affecting ◽  
Trial Without Catheter
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