Factors associated with the success of trial without catheter in acute urinary retention due to benign prostatic hyperplasia

Purpose: This study aims to evaluate the parameters that can predict the success or failure of trial without catheter (TWOC) for acute urinary retention (AUR) due to benign prostatic hyperplasia (BPH). Materials and Methods: A prospective cohort study was conducted to include 73 medically treated patients with AUR due to BPH. All patients underwent catheterization and were started on alfuzosin (10 mg/day), followed by TWOC. Age, international prostate symptom score (IPSS), quality of life, prostate volume, and urine volume after catheterization were analyzed. Results: Patients' mean age was 74.23 ± 9.63 years; the first successful and failed TWOC was reported in 47 (64.4%) and 26 patients (35.6%), respectively. On the one hand, 89.4% of the patients continued medical treatment with alfuzosin (10 mg/day) in the first successful TWOC group. On the other hand, 30.8% showed the second successful TWOC and continued medical treatment in the first TWOC failure group. The uni- and multivariable analyses in this study showed that severe lower urinary tract symptoms (IPSS ≥20 points), prostatic pain during digital rectal examination (DRE), high urine volume after catheterization (≥950 mL), and high blood urea (≥4.55 mmol/L) were the predictive factors of TWOC failure. Conclusion: Severe lower urinary tract symptoms, prostatic pain during DRE, large urine volume after catheterization, and high blood urea are the predictive factors for TWOC failure in AUR due to BPH.