[Continuous bladder irrigation following transurethral resection of the prostate (TURP)].
OBJECTIVE
We investigated whether continuous bladder irrigation after Transurethral Resection of the Prostate (TURP) would prevent catheter obstruction by the clot.


METHODS
We analyzed data from 761 patients registered in "a multi-institutional study of TURP clinical pathway" sponsored by the Ministry of Health, Labor and Welfare between 2001 and 2003. The difference of clinical backgrounds of the cases, resected weight, operating time, risk of being feverish, risk of catheter obstruction and chance of postoperative Transurethral Fulguration (TUF) between each institution were investigated. The risk factor of catheter obstruction is characterized and the significance of continuous bladder irrigation is discussed.


RESULTS
The incidence of catheter obstruction in the four institutions, in which 90% or more of patients underwent continuous bladder irrigation, was significantly lower than that in the three institutions, in which continuous bladder irrigation was performed in selected patients whose hematuria was severe (4.4% VS 12.9%, p<0.001). There was no difference in the frequency of either pyrexia or postoperative TUF. Logistic regression analysis showed that significant factors for catheter obstruction are continuous bladder irrigation, resected tissue weight and preoperative urinary infection.


CONCLUSIONS
Routine continuous bladder irrigation achieved a lower incidence of catheter obstruction. However, we recommend that urologists should decide whether to perform routine continuous irrigation, considering the frequency of catheter obstruction, safety, labor and cost.
Nojiri
Yoshikatsu
Y
Department of Urology, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan.
Okamura
Kikuo
K
Kinukawa
Tsuneo
T
Ozawa
Hideo
H
Saito
Shiro
S
Okumura
Kazuhiro
K
Terai
Akito
A
Takei
Mineo
M
D019091:Critical Pathways; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000517:prevention & control*; D011184:Postoperative Period; D007507:Therapeutic Irrigation / Q000379:methods; D020728:Transurethral Resection of Prostate; D001743:Urinary Bladder; D014546:Urinary Catheterization / Q000009:adverse effects