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Updated: Sep 11, 2025

Vessel-sparing Excision and Primary Anastomosis
Published on: January 7, 2019
Postoperative Hematuria Is the Key to Achieving No Indwelling Urethral Catheter Immediately After Prostatic Urethral
Hidero Minami1,2, Go Anan3, Kanya Kaga4
1Department of Urology, Hanyu General Hospital, Saitama, Japan.
Objectives:
The postoperative urethral catheter-free has been possible immediately after prostatic urethral lift (PUL) for benign prostatic hyperplasia; however, there are no specific criteria for urethral catheter-free status. This study evaluated the efficacy of the criteria for urethral catheter-free status after PUL.
Methods:
We evaluated the criteria for urethral catheter-free status after PUL on hematuria grade and prospectively reviewed the results. The grade of hematuria was assessed on a scale of five levels. This study was classified as Group A-postoperative urethral catheter-free when hematuria Grade 3 or lower at the end of PUL; and Group B-postoperative urethral catheter insertion when hematuria Grade 4 or higher.
Results:
A total of 45 patients were included in the study. The median age was 81, and the prostate volume was 34 mL. There were 36 patients (80%) in Group A and 9 (20%) in Group B. In Group A, 26 patients (72%) achieved postoperative catheter-free immediately after PUL, and in the other 10 patients, the urethral catheter was inserted due to transient urinary retention. In Group B, 7 patients (78%) achieved postoperative urethral catheter-free 1 day after PUL. There was no significant difference in postoperative voiding status between the two groups.
Conclusions:
We evaluated the utility and safety of a protocol using postoperative hematuria grade as a decision-making tool for early urethral catheter removal following PUL. This hematuria-grade-based catheter removal protocol after PUL was generally feasible and safe.
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