Analysis of medical care and optimazation for patients with acute urinary retention admitted to hospital in Moscow

Pushkar' D.Yu., Malhasyan V.A., Hodyreva L.A., Rasner P.I., Kupriyanov Yu.A., Dudareva A.A., Semenyakin I.V., Engay V.A., Zingerenko M.B., Zinuhov A.F., Mamaev I.E., Otvetchikov I.N., Red'kovich V.I., Suleymanov S.I., Tahirzade T.B., Tedeev V.V., Trushkin R.N., Cyganov S.V., Motin P.I., Lasskiy I.A.

INTRODACTION AND OBJECTIVES: The aim of the survey was to gain information on current acute urinary retention (AUR) treatment in Moscow urology departments. 

METHODS: A survey was sent to 21 urologic departments within Moscow. The questionnaire contained questions on the medical, technical and organizational aspects of AUR. 

RESULTS: We received information on 536 patients. 99.1% of patients were male. The mean age was 69.5 years, 419 (78.2%) patients were retired. 144 (26.9%) patients were previously hospitalized for AUR. In 91.6 % patients AUR was caused by BPH. The mean prostate volume was 69, 5 cc. In 106 (20, 0%) patients bilateral hydronephrosis along with singes of renal failure were detected. Mean PSA level was 6, 5 ng/ml, 99 (18, 6%) patients were biopsied and in 24 (24, 2%) prostate cancer has been found. 461 (86, 0%) have not had any lower urinary tract surgery before admission, 5, 6% had previously undergone TURP. Comorbidities were found in 74% patients. Arterial hypertension (67, 9%) and coronary heart disease (56, 0%) were most prevalent comorbidities. Only 244 (45,5%) patients have been visiting urologist and 364 (67, 9%) patients did not receive any medical care before hospital admission. Among 172 patients who received medication before admission, 159 (92, 4%) patients were prescribed alpha-blockers, 14 (8, 1%) 5α-reductase inhibitors and 27 (15, 7%) patients had been taking homeopathic or herbal products. AUR were managed conservatively in 306 (57%) patients. Only 321 (59, 9%) patients have been prescribed medication within the hospital. Tamsulosin 31, 9% were the most prescribed drug. 201 patients underwent surgery with a trocar cystostomy. Surgery complications were detected in 17 (5, 3%) patients. UTI were found in 7 (2,2%) patients, profuse hematuria in 6 (1,9%), hemorrhage in 2 (0,6%), abdominal phlegmon and sigmoid colon injury in 1 (0,3%) patient. 

CONCLUSIONS: The present survey shows that the almost half of patients with AUR receive no follow-up or treatment before hospital admission. It seems that patients screening and involving them in active surveillance might help patients to avoid AUR and surgery. 

Authors declare lack of the possible conflicts of interests. 

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acute urinary retention, benign prostatic hyperplasia, optimization of treatment