Bladder outlet obstruction in men with acute urinary retention: an urodynamic study

Area of Science:

• Urology
• Andrology
• Surgical Oncology

Background:

• Acute urinary retention (AUR) is a common urological emergency in older men.
• Bladder outlet obstruction (BOO) is a frequent cause of AUR, often due to benign prostatic hyperplasia.
• Early identification of BOO can guide treatment decisions, including timely surgical intervention.

Purpose of the Study:

• To identify clinical predictors of bladder outlet obstruction (BOO) in men presenting with their first episode of spontaneous acute urinary retention (AUR).
• To develop a predictive model (nomogram) to facilitate patient selection for early de-obstructive prostate surgery.

Main Methods:

• A multichannel urodynamic investigation was conducted in 156 men aged 50 years or older within five days of AUR.
• Clinical parameters including age, drained volume, and pain intensity were evaluated.
• Multivariable logistic regression and nomogram construction were used to predict BOO (defined as BOO-index >40).

Main Results:

• Over half (50.6%) of the men were diagnosed with BOO.
• Age, drained volume, and pain intensity were independently associated with BOO.
• The developed nomogram predicted BOO with 78.2% accuracy, demonstrating good discrimination and calibration.

Conclusions:

• Routine clinical parameters—age, drained volume, and pain intensity—are significant predictors of BOO in men with AUR.
• A nomogram incorporating these factors can aid in identifying patients who may benefit from early surgical intervention.
• External validation of the nomogram is recommended to confirm its generalizability.