Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2024 May 14;5(8):732-747.
doi: 10.1002/bco2.369. eCollection 2024 Aug.

Immediate or delayed trial without catheter in acute urinary retention in males: A systematic review

Veronika S Christensen  1 , Marius Skow  2   3 , Signe A Flottorp  4   5 , Hilde Strømme  6 , Ibrahimu Mdala  4 , Odd Martin Vallersnes  3   4
Affiliations
Review

Immediate or delayed trial without catheter in acute urinary retention in males: A systematic review

Veronika S Christensen et al. BJUI Compass. .

Erratum in

  • Erratum.
    [No authors listed] [No authors listed] BJUI Compass. 2024 Dec 30;5(12):1324-1329. doi: 10.1002/bco2.482. eCollection 2024 Dec. BJUI Compass. 2024. PMID: 39744071 Free PMC article.

Abstract

Objective: To compare the success of establishing spontaneous micturition following immediate trial without catheter (TWOC) to delayed TWOC in males catheterized for acute urinary retention.

Materials and methods: In this systematic review, we included studies reporting success rates of immediate TWOC or delayed TWOC (≤30 days) among males ≥18 years of age catheterized for acute urinary retention. We excluded studies on suprapubic catheterization, postoperative/perioperative catheterization and urinary retention related to trauma. We searched the following databases: MEDLINE, Embase, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Open Grey and Clinicaltrials.gov. The search was concluded on 30 November 2022. There were no restrictions on language or publication date. Risk of bias was assessed using the ROB 2.0 and ROBINS-I tools. We did random-effects restricted maximum likelihood model meta-analyses. Certainty of evidence was assessed using GRADE.

Results: We included 61 studies. In two randomized controlled trials (RCTs), both with some concerns for risk of bias, including in total 174 participants, the relative success rate was 1.22 (95% CI 0.84-1.76) favouring delayed TWOC. In two comparative cohort studies, both with serious risk of bias, including 642 participants, the relative success rate was 1.18 (0.94-1.47) favouring delayed TWOC. One study was excluded from this meta-analysis because of critically low quality. Four studies reporting success rates for cohorts with immediate TWOC, all with serious risk of bias, including 409 participants, had an overall success rate of 47% (29-66). Fifty-two studies reporting success rates for cohorts with delayed TWOC, all with serious risk of bias, including 12 489 participants, had an overall success rate of 53% (49-56). The certainty of the evidence was considered low for the RCTs and very low for the rest.

Conclusion: There was a limited number of appropriately designed studies addressing the research question directly. The evidence favours neither approach.

Keywords: alpha‐blocker; benign prostatic hyperplasia; catheterization; trial without catheter; urinary retention.

PubMed Disclaimer

Conflict of interest statement

The authors report no conflict of interests.

Figures

FIGURE 1
FIGURE 1
Flow diagram for the search and selection of studies, PRISMA 2020.
FIGURE 2
FIGURE 2
Meta‐analysis of RCTs comparing delayed and immediate TWOC.
FIGURE 3
FIGURE 3
Meta‐analysis of comparative cohort studies comparing delayed and immediate TWOC.
See this image and copyright information in PMC

References

    1. Emberton M, Anson K. Acute urinary retention in men: an age old problem. BMJ. 1999;318(7188):921–925. 10.1136/bmj.318.7188.921 - DOI - PMC - PubMed
    1. Billet M, Windsor TA. Urinary retention. Emerg Med Clin North Am. 2019;37(4):649–660. 10.1016/j.emc.2019.07.005 - DOI - PubMed
    1. Jacobsen SJ, Jacobson DJ, Girman CJ, Roberts RO, Rhodes T, Guess HA, et al. Natural history of prostatism: risk factors for acute urinary retention. J Urol. 1997;158(2):481–487. 10.1016/S0022-5347(01)64508-7 - DOI - PubMed
    1. Cathcart P, van der Meulen J, Armitage J, Emberton M. Incidence of primary and recurrent acute urinary retention between 1998 and 2003 in England. J Urol. 2006;176(1):200–204. 10.1016/S0022-5347(06)00509-X - DOI - PubMed
    1. Yoon PD, Chalasani V, Woo HH. Systematic review and meta‐analysis on management of acute urinary retention. Prostate Cancer Prostatic Dis. 2015;18(4):297–302. 10.1038/pcan.2015.15 - DOI - PubMed

LinkOut - more resources