{"title":"尿潴留妇女试验拔管成功的预测因素","authors":"Masato Takanashi, Hiroki Ito, Takeshi Fukazawa, Risa Shinoki, Tadashi Tabei, Takashi Kawahara, Kazuki Kobayashi","doi":"10.1111/luts.12464","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Objective</h3>\n \n <p>To investigate the outcome, determine the predictors for the success of, and evaluate the efficacy of pharmacokinetic therapy on trial catheter removal for women with urinary retention.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>Inclusion criteria were female patients with acute urinary retention defined as painful, palpable, or percussive bladder, when the patient is unable to pass any urine, accompanied by postvoid residual (PVR) > 250 ml, and who underwent trial catheter removal between July 2009 and July 2019. Before trial catheter removal, alpha-blockers alone or alpha-blockers and parasympathomimetics (bethanechol or distigmine bromide) were used to facilitate spontaneous voiding in some cases.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Fifty-nine of 104 (56.7%) women with urinary retention were catheter-free post trial. There was no significant difference between successful and non-successful trials in average age (<i>p</i> = .392), median ECOG (Eastern Cooperative Oncology Group) performance status (<i>p</i> = .374), diabetes mellitus (<i>p</i> = .842), dementia (<i>p</i> = .801), previous history of cerebrovascular events (<i>p</i> = .592), or intrapelvic surgery (<i>p</i> = .800). Oral medications were administered for 39/59 (66.1%) in the success group and 30/45 (66.7%) patients in the non-success groups (<i>p</i> = .598).</p>\n \n <p>Serum albumin (3.2 ± 0.7 g/dl and 2.8 ± 0.8 g/dl, <i>p</i> = .039) and total protein values (6.5 ± 0.8 g/dl and 6.0 ± 1.0 g/dl, <i>p</i> = .038) at diagnosis of urinary retention were higher in the success group than the non-success group, respectively.</p>\n \n <p>Multivariate logistic regression found that a serum albumin >3 g/dl was an independent predictor of successful trial catheter removal for women with urinary retention (<i>p</i> = .030, odds ratio [OR] 3.3, 95% confidence interval [CI] of OR 1.1–9.9). Age < 70 years old was a likely predictor of successful trial catheter removal (<i>p</i> = .066, OR 4.8, 95% CI of OR 0.9–25.0).</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>This is the first retrospective study to investigate the predictive factors for successful trial catheter removal in women with urinary retention. A serum albumin value >3 mg/dl at diagnosis of urinary retention was a significant independent predictor of catheter-free status after trial catheter removal, and age < 70 years-old was a possible contributor. There was no evidence that oral medication contributed to catheter-free status.</p>\n </section>\n </div>","PeriodicalId":18028,"journal":{"name":"LUTS: Lower Urinary Tract Symptoms","volume":null,"pages":null},"PeriodicalIF":1.5000,"publicationDate":"2022-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"1","resultStr":"{\"title\":\"Predictive factors for the success of trial catheter removal for women with urinary retention\",\"authors\":\"Masato Takanashi, Hiroki Ito, Takeshi Fukazawa, Risa Shinoki, Tadashi Tabei, Takashi Kawahara, Kazuki Kobayashi\",\"doi\":\"10.1111/luts.12464\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Objective</h3>\\n \\n <p>To investigate the outcome, determine the predictors for the success of, and evaluate the efficacy of pharmacokinetic therapy on trial catheter removal for women with urinary retention.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>Inclusion criteria were female patients with acute urinary retention defined as painful, palpable, or percussive bladder, when the patient is unable to pass any urine, accompanied by postvoid residual (PVR) > 250 ml, and who underwent trial catheter removal between July 2009 and July 2019. Before trial catheter removal, alpha-blockers alone or alpha-blockers and parasympathomimetics (bethanechol or distigmine bromide) were used to facilitate spontaneous voiding in some cases.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>Fifty-nine of 104 (56.7%) women with urinary retention were catheter-free post trial. There was no significant difference between successful and non-successful trials in average age (<i>p</i> = .392), median ECOG (Eastern Cooperative Oncology Group) performance status (<i>p</i> = .374), diabetes mellitus (<i>p</i> = .842), dementia (<i>p</i> = .801), previous history of cerebrovascular events (<i>p</i> = .592), or intrapelvic surgery (<i>p</i> = .800). Oral medications were administered for 39/59 (66.1%) in the success group and 30/45 (66.7%) patients in the non-success groups (<i>p</i> = .598).</p>\\n \\n <p>Serum albumin (3.2 ± 0.7 g/dl and 2.8 ± 0.8 g/dl, <i>p</i> = .039) and total protein values (6.5 ± 0.8 g/dl and 6.0 ± 1.0 g/dl, <i>p</i> = .038) at diagnosis of urinary retention were higher in the success group than the non-success group, respectively.</p>\\n \\n <p>Multivariate logistic regression found that a serum albumin >3 g/dl was an independent predictor of successful trial catheter removal for women with urinary retention (<i>p</i> = .030, odds ratio [OR] 3.3, 95% confidence interval [CI] of OR 1.1–9.9). Age < 70 years old was a likely predictor of successful trial catheter removal (<i>p</i> = .066, OR 4.8, 95% CI of OR 0.9–25.0).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>This is the first retrospective study to investigate the predictive factors for successful trial catheter removal in women with urinary retention. A serum albumin value >3 mg/dl at diagnosis of urinary retention was a significant independent predictor of catheter-free status after trial catheter removal, and age < 70 years-old was a possible contributor. 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引用次数: 1
摘要
目的探讨尿潴留患者临床拔管的效果，确定成功的预测因素，并评价药代动力学治疗尿潴留的疗效。方法纳入标准为2009年7月至2019年7月期间接受拔管试验的女性急性尿潴留患者，急性尿潴留定义为膀胱疼痛、可触及或冲击，患者无法排出任何尿液，伴有空后残留(PVR) 250 ml。在拔除试验导管之前，在某些情况下，单独使用α -受体阻滞剂或α -受体阻滞剂和副交感神经模拟药物(比萘酚或溴化异丁胺)来促进自然排尿。结果104例女性尿潴留患者中59例(56.7%)术后无导尿管。在平均年龄(p = 0.392)、ECOG(东部肿瘤合作组)中位表现状态(p = 0.374)、糖尿病(p = 0.842)、痴呆(p = 0.801)、既往脑血管事件史(p = 0.592)或盆腔内手术(p = 0.800)方面，成功试验与不成功试验之间无显著差异。成功组39/59(66.1%)患者口服药物治疗，不成功组30/45(66.7%)患者口服药物治疗(p = .598)。尿潴留诊断时，成功组血清白蛋白值(3.2±0.7 g/dl和2.8±0.8 g/dl, p = 0.039)和总蛋白值(6.5±0.8 g/dl和6.0±1.0 g/dl, p = 0.038)分别高于未成功组。多因素logistic回归发现血清白蛋白3 g/dl是尿潴留女性试验拔管成功的独立预测因子(p = 0.030，优势比[OR] 3.3, 95%可信区间[CI]为OR 1.1-9.9)。年龄70岁可能是成功拔管试验的预测因素(p = 0.066, OR 4.8, 95% CI OR 0.9-25.0)。结论:这是首次回顾性研究尿潴留患者成功拔管的预测因素。诊断尿潴留时血清白蛋白值为3 mg/dl是试验拔管后无导管状态的重要独立预测因子，年龄为70岁可能是一个因素。没有证据表明口服药物有助于无导管状态。
Predictive factors for the success of trial catheter removal for women with urinary retention
Objective
To investigate the outcome, determine the predictors for the success of, and evaluate the efficacy of pharmacokinetic therapy on trial catheter removal for women with urinary retention.
Methods
Inclusion criteria were female patients with acute urinary retention defined as painful, palpable, or percussive bladder, when the patient is unable to pass any urine, accompanied by postvoid residual (PVR) > 250 ml, and who underwent trial catheter removal between July 2009 and July 2019. Before trial catheter removal, alpha-blockers alone or alpha-blockers and parasympathomimetics (bethanechol or distigmine bromide) were used to facilitate spontaneous voiding in some cases.
Results
Fifty-nine of 104 (56.7%) women with urinary retention were catheter-free post trial. There was no significant difference between successful and non-successful trials in average age (p = .392), median ECOG (Eastern Cooperative Oncology Group) performance status (p = .374), diabetes mellitus (p = .842), dementia (p = .801), previous history of cerebrovascular events (p = .592), or intrapelvic surgery (p = .800). Oral medications were administered for 39/59 (66.1%) in the success group and 30/45 (66.7%) patients in the non-success groups (p = .598).
Serum albumin (3.2 ± 0.7 g/dl and 2.8 ± 0.8 g/dl, p = .039) and total protein values (6.5 ± 0.8 g/dl and 6.0 ± 1.0 g/dl, p = .038) at diagnosis of urinary retention were higher in the success group than the non-success group, respectively.
Multivariate logistic regression found that a serum albumin >3 g/dl was an independent predictor of successful trial catheter removal for women with urinary retention (p = .030, odds ratio [OR] 3.3, 95% confidence interval [CI] of OR 1.1–9.9). Age < 70 years old was a likely predictor of successful trial catheter removal (p = .066, OR 4.8, 95% CI of OR 0.9–25.0).
Conclusions
This is the first retrospective study to investigate the predictive factors for successful trial catheter removal in women with urinary retention. A serum albumin value >3 mg/dl at diagnosis of urinary retention was a significant independent predictor of catheter-free status after trial catheter removal, and age < 70 years-old was a possible contributor. There was no evidence that oral medication contributed to catheter-free status.
期刊介绍：
LUTS is designed for the timely communication of peer-reviewed studies which provides new clinical and basic science information to physicians and researchers in the field of neurourology, urodynamics and urogynecology. Contributions are reviewed and selected by a group of distinguished referees from around the world, some of whom constitute the journal''s Editorial Board. The journal covers both basic and clinical research on lower urinary tract dysfunctions (LUTD), such as overactive bladder (OAB), detrusor underactivity, benign prostatic hyperplasia (BPH), bladder outlet obstruction (BOO), urinary incontinence, pelvic organ prolapse (POP), painful bladder syndrome (PBS), as well as on other relevant conditions. Case reports are published only if new findings are provided.
LUTS is an official journal of the Japanese Continence Society, the Korean Continence Society, and the Taiwanese Continence Society. Submission of papers from all countries are welcome. LUTS has been accepted into Science Citation Index Expanded (SCIE) with a 2011 Impact Factor.
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