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.
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).


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).


CONCLUSIONS
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.
Department of Urology, Dujiangyan Medical Center , Dujiangyan , PR China.
Yuan
Y
Zhengyong
He
H
Changxiao
Yan
Y
Shibing
Wu
W
Caiwen
D000368:Aged; D000369:Aged, 80 and over; D002408:Catheters, Indwelling; D003131:Combined Modality Therapy; D020878:Device Removal; D004359:Drug Therapy, Combination; D018120:Finasteride / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D009129:Muscle Tonus / Q000502:physiology*; D009130:Muscle, Smooth / Q000502:physiology; D011470:Prostatic Hyperplasia / Q000150:complications*; D013449:Sulfonamides / Q000627:therapeutic use; D000077409:Tamsulosin; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000502:physiology*; D014546:Urinary Catheterization; D016055:Urinary Retention / Q000209:etiology / Q000534:rehabilitation / Q000628:therapy*; D064804:Urological Agents / Q000627:therapeutic use
D013449:Sulfonamides; D064804:Urological Agents; D018120:Finasteride; D000077409:Tamsulosin
acute urinary retention; benign prostatic hyperplasia; bladder training; trial without catheter