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Urinary bladder characteristics via ultrasound as predictors of acute urinary retention in men with benign prostatic hyperplasia

Ho CC, Ngoo KS, Hamzaini AH, Rizal AM, Zulkifli MZ

Clin Ter, 2014;165(2):75-81.

PMID: 24770808 DOI: 10.7471/CT.2014.1680

OBJECTIVE: To determine the clinical utility of urinary bladder and prostate characteristics measured by ultrasound scan in predicting acute urinary retention (AUR) for men with bladder outlet obstruction with an underlying benign prostate hyperplasia (BPH).
MATERIALS AND METHODS: Consecutive men aged ≥50 years presenting with lower urinary tract symptoms (LUTS) or AUR were prospectively recruited in this cross-sectional study. International prostatic symptom score (IPSS) and serum prostate-specific antigen (PSA) were recorded. High-resolution ultrasound was used to measure bladder detrusor thickness (DT, mm), prostatic volume (PV, cm3), intravesical prostatic protrusion (IPP, mm), bladder wall thickness (BWT,mm), intravesical volume and bladder radius. The latter two parameters were used to estimate bladder weight (UEBW, g), assuming a spherical bladder.
RESULTS: Among selected patients, thirty had AUR while 32 men presented with LUTS only. There were significant differences between those with and without AUR in their age (70.5 vs 66.0, p=0.017), IPSS (24.0 vs 18.5, p=0.009), serum PSA (6.18 vs 1.77, p=0.002), PV (56.7 vs 32.4, p=0.006), BWT (5.0 vs 4.4, p=0.034) and UEBW (39.1 vs 25.0, p=0.0003). Multivariate analysis revealed high IPSS and UEBW to be predictors for AUR. UEBW was the strongest predictor of AUR: area under ROC curve was 0.767, with sensitivity and specificity of 63.3% and 87.5%, respectively, at cut-off point of 35 g. The likelihood ratio for AUR was also best with UEBW≥35 g.
CONCLUSIONS: Combined with IPSS, ultrasound determined bladder characteristic, particularly UEBW, is a useful tool in predicting AUR in men with BPH.

Matched MeSH terms: Urinary Retention/etiology*

Uterine inversion with massive uterovaginal prolapse and multiple bladder stones

Naidu A, Nusee Z, Tayib S

J Obstet Gynaecol Res, 2011 Jun;37(6):633-5.

PMID: 21349130 DOI: 10.1111/j.1447-0756.2010.01401.x

A non-puerperal uterine inversion in advanced uterovaginal prolapse is a rare occurrence. Even more unusual is the presence of bladder calculi in these two conditions, which has not been documented before. We report a case of acute urinary retention secondary to severe uterovaginal prolapse associated with uterine inversion and multiple bladder calculi.

Matched MeSH terms: Urinary Retention/etiology

Severe urological complication of leech bite in the tropics

Hamid MS, Mohd Nor GR

Br J Urol, 1996 Jan;77(1):164-5.

PMID: 8653299

Matched MeSH terms: Urinary Retention/etiology*

Incomplete bladder emptying due to labial fusion in a pubertal girl: a delayed consequence of female circumcision

Awang NA, Viegas C, Viegas OAC

Aust N Z J Obstet Gynaecol, 2004 Aug;44(4):372-3.

PMID: 15282020 DOI: 10.1111/j.1479-828X.2004.00261.x

Matched MeSH terms: Urinary Retention/etiology

Ultrasonography and clinical outcomes following surgical anti-incontinence procedures (Monarc vs Miniarc)

Lo TS, Tan YL, Wu PY, Cortes EF, Pue LB, Al-Kharabsheh A

Eur J Obstet Gynecol Reprod Biol, 2014 Nov;182:91-7.

PMID: 25265496 DOI: 10.1016/j.ejogrb.2014.09.015

To evaluate the ultrasound morphology and its clinical outcome among women who had undergone Miniarc™ vs Monarc™ in the treatment of stress urinary incontinence (SUI).

Matched MeSH terms: Urinary Retention/etiology

A demographic profile of patients undergoing transurethral resection of the prostate for benign prostate hyperplasia and presenting in acute urinary retention

Loh SY, Chin CM

BJU Int, 2002 Apr;89(6):531-3.

PMID: 11942958

OBJECTIVE: To evaluate, in a prospective study, the demographic profile of patients with benign prostate enlargement who presented in acute urinary retention (AUR).

PATIENTS AND METHODS: The study comprised all patients admitted for transurethral resection of the prostate and categorised into two groups, i.e. those presenting in AUR or electively. The factors evaluated included the length of hospitalization, the patients' occupation, their duration of symptoms and reasons for not seeking treatment.

RESULTS: There was no significant difference in the mean age and occupational status of the two groups but those in AUR had more complications and a longer hospital stay after surgery; 60% of these men had had their urinary symptoms for > 1 year. When asked why they did not seek treatment earlier, 35% reported fear of surgery, while 41% thought that their symptoms were a normal part of ageing.

CONCLUSION: There is a need to raise the level of public awareness of benign prostatic enlargement because those who present with AUR incur excess morbidity and longer hospitalization that could otherwise be avoided through earlier treatment and elective surgery.

Matched MeSH terms: Urinary Retention/etiology

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