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Related Concept Videos

Urodynamic Studies: Uroflowmetry01:19

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Uroflowmetry is a non-invasive urodynamic test designed to measure various aspects of urination, including volume, flow rate, and the time to void. This test is crucial for diagnosing and assessing conditions such as bladder outlet obstruction, bladder dysfunction, incomplete bladder emptying, incontinence, and urinary tract blockages caused by benign prostatic hyperplasia (BPH) and urethral strictures.Pre-Test Instructions:Before a uroflowmetry test, patients are typically advised to drink...
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Related Experiment Video

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Vessel-sparing Excision and Primary Anastomosis
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Predicting Initial Trial Without Catheter Failure After Prostate Deobstruction Surgery Using Preoperative

Jen-Hao Kuo1, Ming-Syun Chuang1, Hau-Chern Jan1

  • 1Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.

International Neurourology Journal
|November 4, 2025
PubMed
Summary

Predicting trial without catheter (TWOC) failure after prostate surgery is key. Detrusor underactivity and low bladder outlet obstruction are significant predictors of TWOC failure, guiding postoperative care.

Keywords:
Prostatic hyperplasiaUrinary bladder neck obstructionUrinary bladder, UnderactiveUrinary catheterizationUrodynamics

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Area of Science:

  • Urology
  • Surgical Outcomes
  • Lower Urinary Tract Symptoms

Background:

  • Prostate deobstruction surgery effectively treats benign prostatic obstruction.
  • Postoperative trial without catheter (TWOC) can fail, necessitating recatheterization.
  • Identifying predictors of TWOC failure is crucial for patient management.

Purpose of the Study:

  • To identify clinical and urodynamic predictors of initial TWOC failure after prostate deobstruction surgery.
  • To improve postoperative management strategies for patients undergoing prostate deobstruction procedures.

Main Methods:

  • Retrospective single-center study of 327 men undergoing prostate deobstruction surgery (2018-2024).
  • Evaluation of clinical data, prostate volume, uroflowmetry, and multichannel urodynamics.
  • Logistic regression analysis to determine factors predicting initial TWOC failure (recatheterization within 1 week).

Main Results:

  • 12.5% of patients (41/327) experienced initial TWOC failure.
  • Detrusor underactivity (DU) and low bladder outlet obstruction (BOO) were independent predictors of TWOC failure.
  • Combined DU and low BOO significantly increased failure risk; high BOO with no DU decreased risk.

Conclusions:

  • Preoperative urodynamics aid in stratifying initial TWOC failure risk.
  • Patients with DU and low BOO may benefit from prolonged catheterization.
  • Early catheter removal is feasible for patients with high BOO and preserved detrusor function, even with elevated PVR.