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• W2783755595 abstract "INTRODUCTION:Urinary retention is a one of the most common and distressing emergency in urology. Though acute retention is more dramatic in presentation and more common, chronic retention is more obscure and may present to the outpatient clinic rather than as emergency (1). The incomplete emptying of the bladder and retention of large urine residue without the patient realizing it over a long period carries a guarded prognosis after surgery. Urinary retention is described as the inability to empty the bladder completely or not at all. It may be classify as acute or chronic. Acute retention is a sudden painful retention which drains less than 1000ml on catheterization. The International Continence Society(ICS) defines Chronic retention of urine (CUR) as a non-painful bladder that remains palpable or percussible after the patient has passed urine(2). Such patients may be incontinent. Chronic urinary retention is defined as post void residue of more than 300ml or painless palpable bladder after voiding or more than 1000ml drained after catheterization(3). Benign prostatic hypertrophy is the most common etiology in men. AIM: To study whether prostate size influences the outcome of TURP in patients with chronic retention.METHODOLOGY: This was a prospective study conducted in the department of urology CMC vellore, from 1st August 2011 to 31st January 2014. All patients with chronic retention presenting to the department and planned for TURP were enrolled. Patients were evaluated by IPSS scoring, digital rectal examination, TRUS estimation of prostate volume and intravesical prostate protrusion(IPP), BMI, creatinine and urine culture. Uroflometry and post void residue (PVR) was measured for those not on catheter. The resected specimen was measured in a weighing scale and post operative PVR was measured for all patients. Patients with urethral stricture, carcinoma prostate, proven neurogenic bladder, voiding dysfunction and vesical calculus were excluded.The primary end point was successful voiding (catheter free) with PVR of less than 150ml after the operation.RESULTS: We enrolled 139 patients with chronic retention in this study, 118 patients were evaluated. The mean age was 65 [65.54±8.735 (43-86)], and prostate volume was 47.23±26.75 (8.71 to 172). Patients with large prostate volume (>40ml) had higher of successful outcome following TURP (p- 0.014). There was no significant correlation of the prostate size with age (Pearson correlation coefficient 0.142), BMI (Pearson correlation coefficient -0.026) and IPSS. Patients who present with acute on chronic retention had a significantly larger prostate (51.4 Vs 34.6ml, p=0.008) and greater intravesical protrusion (7.8 Vs 6mm). Digital rectal examination correlated well with TRUS volume (Pearson correlation 0.489). Intravesical prostate more than 10mm seem to have a better outcome but it was not statistically significant (p- 0.370). Ninety –four percent had successful outcome after TURP (catheter-free), 8 patients required either CISC or indwelling catheter.CONCLUSION: Majority (94%) of the patients with chronic urinary retention had successful outcome after TURP. Patients with larger prostate are more likely to be catheter-free following TURP. However, in our study we could not establish correlation between IPP and outcome following TURP." @default.
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• W2783755595 date "2014-08-01" @default.
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• W2783755595 title "Can TRUS estimation of the prostate volume predict the outcome of TURP in Chronic Urinary Retention" @default.
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