Effects of forced diuresis achieved by oral hydration and oral diuretic administration on uroflowmetric parameters and clinical waiting time of patients with lower urinary tract symptoms.
BACKGROUND
We studied the impact of diuresis forced by oral hydration or single-dose oral diuretic administration on uroflowmetric parameters and clinical waiting time of patients with lower urinary tract symptoms.


METHODS
A total of 58 patients with a mean age of 59 (range 41-77) years who presented with lower urinary tract symptoms were included in the study. The patients were grouped with respect to their International Prostate Symptom Scores as having mild, moderate, or severe symptoms. The prostatic volumes of the patients were calculated using transrectal ultrasound. Uroflowmetric measurements were performed on 3 consecutive days. On the 1st day, the test was performed without diuretic stimulation; on the 2nd day, oral hydration was applied, and on the 3rd day, the patients received 20 mg of furosemide orally. Voiding time, maximum flow rate, voided volume, and the time elapsed in minutes until voiding (waiting time) were recorded.


RESULTS
Diuretic stimulation did not significantly alter the uroflowmetric parameters in each symptom group, but the waiting time was significantly reduced. Forced diuresis caused acute urinary retention in 5 of 20 (25%) severely symptomatic patients.


CONCLUSIONS
Forced diuresis with oral hydration or oral administration of diuretics improves patient comfort and test applicability by shortening clinical waiting time and reducing the number of attempts to reach the sufficient urine volume for reliable measurements and can be applied safely for mild and moderately symptomatic patients. On the other hand, the risk of 25% of acute urinary retentions should be reconsidered, and the decision about diuretic stimuli should be made carefully by the clinician in severely symptomatic patients.
Oztürk
Bülent
B
2nd Urology Clinic, Ankara Numune Education and Research Hospital, Ankara, Turkey. bulentoz@yahoo.com
Cetinkaya
Mesut
M
Oztekin
Volkan
V
Inal
Gürdal
G
Adsan
Oztuğ
O
Uğurlu
Ozgür
O
Ozden
Cüneyt
C
D000284:Administration, Oral; D000328:Adult; D000368:Aged; D001071:Appointments and Schedules; D004231:Diuresis / Q000187:drug effects*; D004232:Diuretics / Q000008:administration & dosage* / Q000009:adverse effects; D005440:Fluid Therapy / Q000009:adverse effects / Q000379:methods*; D005665:Furosemide / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D011470:Prostatic Hyperplasia / Q000150:complications; D012212:Rheology / Q000187:drug effects; D013997:Time Factors; D016055:Urinary Retention / Q000209:etiology; D014555:Urination Disorders / Q000175:diagnosis / Q000209:etiology; D014556:Urine / Q000502:physiology; D014563:Urodynamics / Q000187:drug effects*
D004232:Diuretics; D005665:Furosemide