Effectiveness and safety of intermittent catheterisation for the management of acute urinary retention: A prospective, randomised, multicentre, controlled study.

Abstract

Objectives: To assess the efficacy and safety of clean intermittent catheterisation (CIC) in the management of acute urinary retention (AUR) and identify factors those affect the likelihood of recovery of spontaneous urination and the development of adverse events.

Materials and methods: A prospective multicentre comparative randomised study included 129 patients hospitalised in urological hospitals with AUR due to benign prostatic hyperplasia. Patients were randomised into two groups. In group I, the classical tactics of TWOC (drainage of the bladder with a urethral Foley catheter for 3 days) were used, whereas in group II, patients underwent CIC for 3 days. A comparative assessment of the effectiveness of intermittent catheterisation was carried out and compared to the classical tactics of TWOC (trial without catheter/attempt without catheter).

Results: Normal voiding was restored in 25 (35.7%) patients in group I and 26 (44%) patients in group II. The point estimate of the probability of urination recovery on the third day of therapy in group II was 1.5 times higher than that in group I. The difference between these estimates was not statistically significant. In group II, 1 (3.8%) patient recovered spontaneous urination within 1 day, 12 (46.2%) within 2 days, and 13 (50%) by the end of 3 days. On the seventh day, AUR recurred in three (2.3%) patients: two (2.8%) in group I and one (1.7%) in group II. Statistically significant relationships were found between the probability of developing gross haematuria and patient age, as well as between possible urethrorrhagia and a history of AUR, between age and the use of α1-blockers at the time of AUR.

Conclusion: Intermittent catheterisation is an effective treatment for AUR. Its main advantages include the possibility of outpatient management, earlier recovery of spontaneous urination and significantly less severe catheter-associated lower urinary tract symptoms.