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Expectant long‐term follow‐up of patients with chronic urinary retention
Author(s) -
Abello Alejandro,
DeWolf William C.,
Das Anurag K.
Publication year - 2019
Publication title -
neurourology and urodynamics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 90
eISSN - 1520-6777
pISSN - 0733-2467
DOI - 10.1002/nau.23853
Subject(s) - medicine , urinary retention , complication , cohort , prostate , surgery , adverse effect , urology , cancer
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.