Expectant long‐term follow‐up of patients with chronic urinary retention

Aims To describe urologic complications in patients with chronically elevated post‐void residual (PVR) volumes and to evaluate other related risk factors during a long‐term follow‐up in patients managed conservatively. Methods Non‐neurogenic patients who refused surgical intervention of the prostate and had PVR volumes >300 mL on two or more separate occasions at least 6 months apart were included. We followed this cohort over time, recorded complications and evaluated risk factors for complications. Results Twenty‐eight men with a mean age of 74 were followed for a median of 56 months (IQR: 26‐101 months); 26 had benign prostatic hyperplasia with a median prostate size of 55 cc. Baseline median PVR was 468 cc (IQR: 395‐828) and follow‐up median PVR was 508 cc (IQR: 322‐714). During follow‐up, 13 patients (46%) had at least one complication with acute urinary retention being the most common occurring in 10 patients (36%) with 15 episodes. Other complications presented in less than 15%, and no patients developed permanent renal insufficiency. Patients with prostate size ≥ 100 cc had significantly higher total number of acute retention episodes ( P ‐value: 0.01). Conclusions Although the presence of CUR could commonly predispose to episodes of acute retention, severe complications are infrequent although present. Additionally, prostate size may play a role in increasing some adverse outcomes. With proper counseling about different complications, patients with retention who denied surgical treatment can be safely followed for at least 5 years without renal deterioration.