尿路動力學檢查對尿滯留病人是否有幫助?
戴盟哲¹、林志杰^1,2、范玉華^1,2、林登龍^1,2、黃志賢^1,2
台北榮民總醫院 泌尿部¹；國立陽明大學醫學院 泌尿學科 書田泌尿科學研究中心²
Does urodynamic study have benefit in patients with acute urinary retention?
Meng-Che Tai¹, Chih-Chieh Lin^1,2, Yu-Hua Fan^1,2, Alex T.L. Lin^1,2, William J Huang^1,2
Department of Urology, Taipei Veterans General Hospital, Taiwan¹;
Department of Urology, School of Medicine and Shu-Tien Urological Institute, National
Yang-Ming University, Taipei, Taiwan²

Purpose:

Acute urinary retention (AUR) is a common urological emergency associated with painful inability to void urine. Urethral catheterization is an immediate management of AUR for bladder decompression. Trial without catheter (TWOC) is a standard management for patients. Repeat catheterization would be done if TWOC is failure. However, urodynamic study recorded bladder capacity, compliance and detrusor pressure at peak flow rate, etc. Therefore, we want to know urodynamic study have benefit in patients with acute urinary retention.

Materials and Methods:

We collected patients with AUR who received pressure-flow study (PFS) from April 2018 to March, 2019 prospectively. Medications, like α1-blocker or bethanechol, can be given or not depend on doctors. All the patients’ Foley were removed after examinations. We define re-catheterization within 7 days as TWOC failure. The patients’ demographic data, questionnaire (IPSS score, OAB-6, OABSS), managements of AUR and the results of PFS were analyzed.

Results:

Totally 88 patients were included for analysis. Thirty-nine patients (44.3%) had successful TWOC (Group I) and 49 patients were failure (Group II). The mean age was 76.0 ± 10.8 years old and man accounted 67%. There was no difference in demographic data, questionnaire and medications usage. In PFS report, acontractile detrusor was significant high in patients with failure TWOC (53.1% vs 12.8%, p=0.000). The median prostate size was 63.5 ± 44.3 cm³ versus 64.3 ± 41.6 cm³, p=0.950.

Conclusions:

In patients with acute urinary retention, acontractile detrusor by urodynamic study had significant higher failure TWOC rate. Thus, urodynamic study had benefit to predict successful TWOC and prevent repeat catheterization.