title: Emergency management of acute urinary retention: results from an all-Ireland urologist practice survey.
abstract: BACKGROUND
  Anecdotal evidence suggests that current service restrictions and operative cancellations are resulting in increased numbers of catheterized men in the community awaiting definitive management of their bladder outlet obstruction. We wished to analyse current admission policies and management strategies of acute urinary retention (AUR) secondary to benign prostatic enlargement (BPE) in Ireland.
  
  
  METHODS
  A total of 58 consultant urologists practicing in Ireland were sent a questionnaire about their management of AUR secondary to BPE. Data was collected relating to initial emergency management, timing of trial without catheter (TWOC), their use of alpha-blockers and follow-up policy.
  
  
  RESULTS
  Urethral catheterization is the initial management of choice by all 42 respondents. The patient is routinely admitted after catheterization by 20/42 consultants (48 %) and 22/42 (52 %) discharge the patient home with a urinary catheter (UC). TWOC is performed on day 2 in 11/20 (55 %) and on day 3 in 9/20 (45 %). In terms of individuals who admit patients presenting with AUR one failed TWOC is an indication for transurethral resection of the prostate in 10/20 (50 %), with 6/20 (30 %) performing a second TWOC on the same admission and 4/20 (20 %) discharging the patient for interval TURP. A total of 83 % of respondents, all of whom work in public institutions, expressed concerns relating to elective admission difficulties for definitive management of catheterized patients following AUR.
  
  
  CONCLUSIONS
  There is variation in the admission policy for AUR in Ireland. Elective admission and operative restrictions for catheterized patients following episodes of AUR are causing concern to the urologists in Ireland.
authors.affiliation: Department of Urology, AMNCH, Tallaght, Dublin 24, Ireland. imcullen@gmail.com
authors.forename: I M
authors.initials: IM
authors.lastname: Cullen
authors.forename: C M
authors.initials: CM
authors.lastname: Dowling
authors.forename: J A
authors.initials: JA
authors.lastname: Thornhill
authors.forename: R
authors.initials: R
authors.lastname: Grainger
mesh_terms: D000208:Acute Disease; D000317:Adrenergic alpha-Antagonists / Q000627:therapeutic use; D019468:Disease Management; D004630:Emergencies; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007494:Ireland; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D011470:Prostatic Hyperplasia / Q000150:complications* / Q000188:drug therapy; D011795:Surveys and Questionnaires; D001748:Urinary Bladder Neck Obstruction / Q000150:complications; D014546:Urinary Catheterization / Q000706:statistics & numerical data*; D016055:Urinary Retention / Q000209:etiology / Q000628:therapy*
chemical_list: D000317:Adrenergic alpha-Antagonists