Randomized controlled trial on the efficacy of bladder training before removing the indwelling urinary catheter in patients with acute urinary retention associated with benign prostatic hyperplasia

Abstract

Objective.The aim of this study was to investigate the efficacy of bladder training before removing the indwelling urinary catheter in patients with acute urinary retention (AUR) associated with benign prostatic hyperplasia (BPH). Material and methods. In total, 845 consecutive patients with their first episode of spontaneous AUR associated with BPH were enrolled in this prospective randomized controlled trial. They were randomly assigned to be given either pharmacological treatment combined with bladder training or pharmacological treatment (tamsulosin 0.2 mg and finasteride 5 mg once daily) with free drainage of urinary catheter for 7 days, and a trial without catheter (TWOC) was performed. Data on patients' baseline demographics, history of BPH, International Prostate Symptom Score, prostate size, serum prostate-specific antigen, intravesical prostatic protrusion, TWOC success rates and related complications were collected and statistically analysed. Results.The two groups of spontaneous AUR patients with BPH were given pharmacological treatment combined with bladder training before catheter removal (n = 440) or pharmacological treatment alone (n = 405) for 7 days. All 845 patients underwent a first TWOC with an overall success rate of 66.9% after first 7 days' catheterization; TWOC was successful in 65.2% of cases in the intervention group and 68.6% in the control group. There was no statistically significant difference in TWOC success rate between the two groups (p > 0.05). Conclusion. This randomized controlled trial showed that bladder training before urinary catheter removal did not increase the chance of TWOC success significantly in spontaneous AUR patients with BPH.

Key Words::

• acute urinary retention
• benign prostatic hyperplasia
• bladder training
• trial without catheter

Acknowledgements

As the first and corresponding author, I would like to express my sincerest gratitude and appreciation to all those who made it possible for us to complete this study. In particular, I would like to extend my thanks to Prof. Doc. Shen Hong, whose help, stimulating suggestions and encouragement helped us throughout the time of researching and writing this paper. Finally, special recognition goes to my wife, Lei Jing, and my son, Yuan Leilei, whose support, encouragement and patience have helped me all my life.

Declaration of interest: The authors declare that they have no financial or personal relationships with other people or companies that could inappropriately influence their work.