Intravesical pressure changes during bladder drainage in patients with acute urinary retention

Area of Science:

• Urology
• Nephrology

Background:

• Acute urinary retention (AUR) is a common urological condition causing significant discomfort and potential complications.
• Current management strategies for AUR include continuous or fractionated urine drainage, with debate on the optimal approach.

Purpose of the Study:

• To compare the efficacy of continuous versus fractionated urine drainage in managing intravesical pressure and blood pressure in patients with acute urinary retention.
• To evaluate patient-reported pain relief and adverse events associated with both drainage methods.

Main Methods:

• A transurethral approach was used to record intravesical pressure and blood pressure in 10 male patients with AUR.
• Patients were randomized to either continuous or fractionated urine drainage.
• Initial 100 cm3 urine evacuation was performed, followed by pressure monitoring.

Main Results:

• Both continuous and fractionated drainage significantly reduced intravesical pressure by approximately 50%, leading to complete pain relief in all patients.
• A significant decrease in blood pressure was observed post-procedure, without clinical manifestations.
• One patient experienced transient hematuria, which resolved spontaneously.

Conclusions:

• Fractionated urine drainage offers no advantage over continuous drainage in managing acute urinary retention.
• Continuous drainage is a sufficient and effective method for relieving intravesical pressure and pain in AUR.
• The findings challenge previous recommendations advocating for fractionated urine drainage in this condition.