The factors that influence the success rate of treatment without using a catheter for the management of acute urinary retention: Comparison of in-and-out catheterization and foley indwelling catheterization

Purpose: Acute urinary retention (AUR) is a serious outcome of benign prostatic hyperplasia (BPH). Although Foley indwelling catheterization is a standard treatment for the conservative management of AUR, we studied the success rate of in-and-out catheterization and the factors that favor a positive outcome of a trial treatment without using a catheter (TWOC). Materials and Methods: We retrospectively reviewed the medical record of all 127 patients who admitted as emergency cases with primary AUR caused by BPH (from January 2002 to August 2005), and these patients underwent in-and-out catheterization or Foley indwelling catheterization and then they underwent TWOC, 1 week later after the first treatment. The patients were divided into four groups: the success group (group I) or failure group (group II) that underwent in-and-out catheterization and the success group (group III) or failure group (group IV) that underwent TWOC. The factors that might influence the outcomes were assessed using logistic regression analysis and Student's t-test. Results: Of the 62 patients who underwent in-and-out catheterization, 30 had no further episodes of AUR during 1-year follow up (group I) and the other patients had repeated episodes (group II). For the clinical parameters, only the retained urine volume was significantly difference between the two groups. The multivariate analysis revealed that the statistically significant influencing factor was urinary retention volume (p<0.01). Conclusions: For patients younger, than 58 years old or the patients with a urinary retention volume less than 580ml, in-and-out catheterization may be considered as the first-line conservative management in preference to bothersome Foley indwelling catheterization.