A study of a trial withdrawing of the urethral catheter in patients with acute urinary retention caused by benign prostatic hyperplasia under the treatment of alpha-adrenergic receptor blocker / 中华老年医学杂志

ABSTRACT

Objective To observe the influence of using alpha-adrenergic receptor blocker and catheterization time on the success rate of a trial without catheter (TWOC) in patients with acute urinary retention (AUR) caused by benign prostatic hyperplasia (BPH).Methods The 124patients from January 2007 to December 2009,aged 62-90 years (mean age 71.3 years),diagnosed as AUR caused by BPH in emergency room,were enrolled in this study.They were randomized to two groups(1) Medication group60 cases,who were given alpha-adrenergic receptor blocker 4 mg daily for 2-3 days before TWOC.Among them,there were 30 cases with catheterization for 3 days,and the rest 30 cases for 7 days;(2)Control group64 cases,who were without alpha-adrenergic receptor blocker.Among them,there were 30 cases with catheterization for 3 days,and the rest 34 cases for 7days.The urine culture was made when the catheter was drawn out.Results (1)The success rate of TWOC was higher in medication group than in control group (71.7% vs.53.1%,x2 =4.523,P=0.033).Both in medication group and control group,the success rate was higher in patients with catheterization for7 days than for 3 days (83.3% vs.60.0%,x2=4.022,P=0.045;67.7% vs.36.7%,P=0.013).(2)After follow-up for 6 months,the patients with catheterization for 7 days had lower incidence rate of second AUR and selective operation (x2 =4.538 and 4.709,P=0.033 and 0.030).(3)There was no significant difference in rate of urinary infection between the patients with catheterization for 7 days and for 3 days (20.3% vs.16.7%,P = 0.603).Conclusions Alpha-adrenergic receptor blocker could increase the success rate of TWOC,and the success rate of TWOC is much higher in patients with catheterization for 7 days than for 3 days,while the urinary infection rate is not significantly increased.