Failure to pass urine following transurethral resection of the prostate [TURP]: does the patient's mode of presentation determine the outcome of TURP?

ABSTRACT

To elucidate possible predictive factors for failure to pass urine following transurethral resection of the prostate [TURP] in patients subjected to TURP for lower urinary tract symptoms [LUTS] secondary to benign prostatic hypertrophy [BPH]. Prospective Study. Urology Unit, Department of Surgery, Mubarak Hospital, Kuwait. Three hundred and fifteen consecutive patients who presented with LUTS secondary to BPH and underwent TURP were included in the study. TURP. Main Outcome Measure: Ability to void after TURP. Out of 315 patients, 26 [8.3%] failed to void after TURP. The mean age of patients was 67 [range 57-92] years. The causes of failure to void after the catheter removal were hypotonic bladder [10 / 26, 38%], persistent infra-vesical obstruction [9/ 26, 35%], diabetic neuropathy [4/ 26, 15%], end stage renal failure neuropathy [1 /26, 4%] and old age [2/ 26, 8%]. 21 / 26 [80.7%] patients who failed to void presented with acute on chronic or chronic urinary retention. The etiology of failure to void post-TURP is multi-factorial but is more common in patients presenting with acute on chronic or chronic urinary retention secondary to hypotonic bladder, diabetic neuropathy and occasionally very old age. Careful pre-operative patient selection and counseling is required in patients with chronic urinary retention about to undergo TURP to minimize the frustrations associated with the management of patients failing to void post-TURP