Relationship between cystoscopic emptying and voiding recovery from acute urinary retention in hospitalized female patients due to non-urological clinical setting
IUGA Academy. Bae J. Jun 30, 2018; 212988; 329 Topic: Dysfunctional Voiding
Dr. Jungbum Bae
Dr. Jungbum Bae

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Relationship between cystoscopic emptying and voiding recovery from acute urinary retention in hospitalized female patients due to non-urological clinical setting

Bae, J1; Yoon, HS1

1: Dongguk University Ilsan Hospital

Introduction: Comorbidities are the contributors of the urinary retention in older patients. Especially hospitalized patients are more easily influenced in the voiding dysfunction. Acute medical problem, postoperative status, variety of medicines can result the acute urinary retention (AUR). Besides medical problem and surgical situation, general condition and ambulation ability could affect the voiding recovery. Especially ambulation could reinforce the abdomen pressure therefore facilitate bladder emptying. Observing cystoscopic drainage of bladder-filled fluid could be an indirect measurement alternative to urodynamic studies.

Objectives: To evaluate the clinical relationship between bladder empying functions and the recovery of spontaneous voiding after an acute urinary retention in older patients admitted to hospitals for non-urological causes using clinical parameters.

Methods: Female patients under AUR due to non-urological problems were evaluated with cystoscopy. All patients were referred to urologic department due to AUR or voiding failure after first urethral catheter removal. Most of patients were prescribed of alpha block agents and periodically followed for voiding recovery. Some patients were intermittent catheterized and some were indwelled urethral catheter. After cystoscopy, patients were periodically checked for spontaneous voiding recovery. During cystoscopy evaluation, treabeculation, bladder empyting status were described. Underlying medical condition, surgical procedure, and performance status were investigated. Under category of bladder emptying status (nearly emptying and incomplete emptying), voiding recovery status was evaluated.

Results: Fifty-six female patients (mean age: 77.1 ± 9.4) were investigated. All patients were hospitalized for at least 15 days (Median 23.1 ± 9.4 days). Cystoscopic complete bladder emptying patients were 39 (70%) and incomplete emptying were 17 (30%). Spontaneous voiding recovery patients after 1 month was observed 31 (79%) in the complete emptying group, 10 (59%) in the incomplete emptying group (p = 0.574). Mean recovery period from AUR was 11.4 days (± 7.3) in the complete emptying group and 15.2 days (± 12.7) in the incomplete group (p<0.05). More comorbidities and worse performance status were showed in the incomplete emptying group (p<0.05). Recovery of spontaneous voiding at 6 months was not significant different between two groups.

Conclusions: Prediction of recovery of spontaneous voiding after acute urinary retention in the hospitalized female patients might not be anticipated by evaluation of bladder emptying capacity measured by cystoscopy. However, more rapid recovery was anticipated by cystoscopy in the retention patients.


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