Chronic urinary retention in the elderly: outcomes for surgery vs long term catheterisation
BAUS ePoster online library. Connell R.
Jun 27, 2018; 211369
Dr. Richard Connell
Dr. Richard Connell
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Abstract
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Introduction: Urinary retention in the elderly is an increasingly common issue. This is the first comparative study reviewing outcomes for elderly patients treated with long term catheters (LTC) or surgery for chronic urinary retention (CUR) that is refractory to medical management.

Methods: Patients presenting from January to December 2016 were identified from prospectively collected emergency and elective databases. Catheterised patients over 80 years with >300mls residual volumes who were refractory to medical treatment and those with high pressure chronic retention were included.

Results: 48 patients with a mean age of 86 years were followed up for an average of 19 months. 26 patients were treated with LTC and 22 patients underwent bipolar trans-urethral resection of the prostate (TURP). The average hospital stay for surgery was 3.5 days. The complication rate after TURP was 45%. 19/22 were voiding at late follow up, 2 of whom required intermittent self-catheterisation (ISC). 17/26 of the LTC group had emergency hospital admissions for urological issues, compared to 6/22 of the surgery group (p=0.04). The mean number of days spent in hospital due to urological issues was 20 following LTC and 2.3 following TURP (p=0.03). 9/26 of the catheter group died during follow up, 3 from catheter associated urosepsis. There were 2 deaths in the surgery group, both from metastatic prostate cancer.

Conclusion: Elderly patients who are catheterised for CUR who undergo surgery are likely to spend significantly less time in hospital due to urological complications than those who are treated with long term catheters.
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