title: Hydronephrosis Predicts Successful Catheter Removal after Painful Urinary Retention - Preliminary Results of a Prospective Single Center Study.
abstract: BACKGROUND
  The study aims to identify candidates who can be managed conservatively after the first episode of spontaneous painful acute urinary retention (AUR).
  
  
  METHODS
  A total of 20 patients with primary spontaneous painful AUR were prospectively included in the study. Twenty-four hours after AUR, the catheter was removed. When residual urinary volume was <100 ml, patients were referred without catheter, when residual urinary volume was ≥100 ml, the catheter was replaced and removed again at day 4, 7 or 10 after AUR, respectively. Receiver operating characteristic curves, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated to assess predictors for successful catheter removal.
  
  
  RESULTS
  Thirteen out of 20 (65%) patients had a successful catheter removal until day 10 after AUR. Among them 12 of 13 (93.2%) had a successful catheter removal until day 4 of AUR. Hydronephrosis urinary volume and Qmax at the time of AUR were significant numeric predictors for failure of successful catheter removal. In addition, we calculated a prediction model combing age + prostate volume + urinary volume + Qmax that highly predicts successful catheter removal (sensitivity 100%, specificity 69%, PPV 64%, NPV 100%).
  
  
  CONCLUSIONS
  We found for the first time a significant association between hydronephrosis and successful catheter removal. Successful catheter removal until day 4 after AUR can safely be managed without immediate transurethral resection of the prostate.
authors.affiliation: Department of Urology, Medical University Innsbruck, Innsbruck, Austria.
authors.forename: Isabel
authors.initials: I
authors.lastname: Heidegger
authors.forename: Josef
authors.initials: J
authors.lastname: Fritz
authors.forename: Hannes
authors.initials: H
authors.lastname: Steiner
authors.forename: Jasmin
authors.initials: J
authors.lastname: Bektic
authors.forename: Renate
authors.initials: R
authors.lastname: Pichler
mesh_terms: D000208:Acute Disease; D000368:Aged; D020878:Device Removal; D006801:Humans; D006869:Hydronephrosis / Q000209:etiology; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D011379:Prognosis; D011446:Prospective Studies; D013997:Time Factors; D062885:Urinary Catheters; D016055:Urinary Retention / Q000150:complications / Q000628:therapy*