Patient outcomes following use of combination therapy for trial without catheter in acute urinary retention patients in a pre-treated population
BAUS ePoster online library. Khela A. 11/10/20; 304115; P8-2
Ms. Aman Khela
Ms. Aman Khela
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Patient outcomes following use of combination therapy for trial without catheter in acute urinary retention patients in a pre-treated population

Khela A1, Khan K2, During V2
1City Hospital Birmingham, United Kingdom, 2New Cross Hospital, Wolverhampton, United Kingdom

Introduction:
The use of alpha blockers (AB) and 5α-Reductase Inhibitors (5ARI) as a combination therapy (CT) for preventing the progression of Lower urinary tract symptoms is well studied. However, the use of CT for persistent cases of Urinary Retention (UR) is less well explored.
This study aims to determine the efficacy of CT in patients who have persistent UR despite treatment with AB.
Methods: Patients presenting with AUR in our unit are catheterized, started on AB, and referred for TWOC. If unsuccessful, long-term catheter, surgery, or CT with delayed TWOC are options offered to patients. Data was collected prospectively for those treated with CT and delayed TWOC.

Results:
95 patients were included from January 2017 - February 2019, average age 78.2yrs. 56.8% of patients had a successful TWOC following CT with average length of time on CT of 2.44 months. 42.1% patients who had successful TWOC were deemed unfit for surgery / aged >80 years. All but 2 patients in this cohort had previous AB and retention/failed TWOC prior to commencement of CT.

Conclusion:
This study suggests that CT and delayed TWOCs is a clinically relevant option in those who may be unfit / unwilling to undergo surgery. This includes those with a large residual volume or already on AB. It is reasonable to try a TWOC after 3 months of CT, with a further attempt at 6 months if the first TWOC fails.
Patient outcomes following use of combination therapy for trial without catheter in acute urinary retention patients in a pre-treated population

Khela A1, Khan K2, During V2
1City Hospital Birmingham, United Kingdom, 2New Cross Hospital, Wolverhampton, United Kingdom

Introduction:
The use of alpha blockers (AB) and 5α-Reductase Inhibitors (5ARI) as a combination therapy (CT) for preventing the progression of Lower urinary tract symptoms is well studied. However, the use of CT for persistent cases of Urinary Retention (UR) is less well explored.
This study aims to determine the efficacy of CT in patients who have persistent UR despite treatment with AB.
Methods: Patients presenting with AUR in our unit are catheterized, started on AB, and referred for TWOC. If unsuccessful, long-term catheter, surgery, or CT with delayed TWOC are options offered to patients. Data was collected prospectively for those treated with CT and delayed TWOC.

Results:
95 patients were included from January 2017 - February 2019, average age 78.2yrs. 56.8% of patients had a successful TWOC following CT with average length of time on CT of 2.44 months. 42.1% patients who had successful TWOC were deemed unfit for surgery / aged >80 years. All but 2 patients in this cohort had previous AB and retention/failed TWOC prior to commencement of CT.

Conclusion:
This study suggests that CT and delayed TWOCs is a clinically relevant option in those who may be unfit / unwilling to undergo surgery. This includes those with a large residual volume or already on AB. It is reasonable to try a TWOC after 3 months of CT, with a further attempt at 6 months if the first TWOC fails.
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