Poster Presentations

withdrawn Life without catheter – optimising clinical decision making for trial of void patients F. HARLEY, H. BASCAND, H. YAO, K. TUMALI, J. CHENG and H. O’CONNELL Western Health, Footscray, Australia Introduction and Objectives: Acute urinary retention is a common referral to the urological service. It is a distressing problem that represents a significant public health issue. The majority of cases occur in males and are linked to benign prostate hyperplasia (BPH). Previous large longitudinal studies on BPH have identified old age, severe lower urinary tract symptoms (LUTS), high postvoid residual (PVR), elevated serum PSA and enlarged prostate as risk factors for spontaneous AUR and the need for surgery. Our study aims to define and determine predictors for failure, so futile TOV attempts can be avoided, and patients can be expedited towards early definitive care. Methods: Patients who underwent a trial of void (TOV) at Western Health between April 2017 and September 2017 were included in this retrospective study. Clinicopathological data were extracted from medical records and included patient demographics, comorbidities, referral source, presentation history, volume of retention, history of medical therapy for benign prostate enlargement, history of previous transurethral resection of prostate gland and history of recent surgery. Univariate analysis was performed to determine factors that are predictive of failing TOV. Statistical analysis was performed using SPSS. Results: During the 6 months study period, there were 210 episodes of TOV involving 169 patients. The median age was 71 (IQR 63–80). There was a male preponderance of 94% vs 6% female. 59% of TOV was following recent surgery, of which 87% of these are urological operations. After excluding patients who were catheterized following recent urological surgery, 82 patients remained. The median age of this subgroup was 75.5 (IQR 67– 82), with 90% male and 10% female patients. The median volume of retention was 888 ml (IQR 608–1000). 15.9% of these patients had retention related to recent non-urological surgery. The pass rate of TOV for this subgroup was 57.3%. On univariate analysis, we found the following to be risk factors for failing TOV: 1) painless retention (p = 0.041, Fisher’s exact test), 2) retention volumes greater than 700 ml (p = 0.043, Chi-Square Test), 3) history of urethral stricture disease (p = 0.038, Fisher’s exact test). The following variables were not independent predictors of failing TOV in our cohort: a blocker use in men, prostate size, history of neurological disease, history of diabetes mellitus, history of opioid use, history of urinary tract infection in the preceding 2 weeks. Conclusions: The rate of successful TOV at our local hospital of 57% is largely comparable with international literature. We identified 3 main predictors of failure in our cohort: painless retention, retention volume greater than 700 ml and history of urethral stricture disease. Our results have helped us better define TOV success vs failure. Furthermore, when used alongside other treatment recommendations from previously published literature, our study has assisted us in formulating a robust TOV guideline from the point of triage to definitive care. We hope our follow up Table 1. Results of prostate artery embolisation