"What we found is that those with acute urinary retention took longer to ultimately pass their trial without a catheter, meaning that they were voiding without the use of any catheterization," says Claire S. Burton, MD.
In this video, Claire S. Burton, MD, discusses the background and notable findings of the study, “Outcomes of Aquablation in men with acute and chronic urinary retention,” for which she served as the lead author. Burton is an FPMRS fellow at Standford University.
Could you describe the background of this study?
In our institution, we started using Aaquablation a little over 2 years ago at this point. In the pivotal trials for Aquablation that were done to support their FDA approval, they excluded men with urinary retention and those who had elevated post void residual of more than 300 mL. We wanted to look at our experience of how those patients did after undergoing treatment with Aquablation.
So, we reviewed our data of 113 patients over our first 15 months of using the Aquablation technology or the robotic waterjet therapy. We wanted to compare how men with and without retention, which we defined acute retention as those requiring either indwelling catheter or intermittent catheterization at least once a day, compared to those with chronic urinary retention in which we defined as men with an elevated post void residual of greater than 300 mL but who were voiding spontaneously, and then compared that with men who were voiding without the need for catheterization or with a PVR of less than 300.
What were some of the notable findings?
In our sample, we have 113 patients, and 28 had acute retention and 16 had chronic urinary retention. What we found is that those with acute urinary retention took longer to ultimately pass their trial without a catheter, meaning that they were voiding without the use of any catheterization. Overall, all but 1 patient in all the groups was able to void spontaneously. It just took longer for the patients who required catheterization prior to surgery.
What was interesting is that we did find that those with chronic retention were no different from those without any urinary retention at all. The decision to catheterize is a patient and provider-based decision, so it's probably a pretty heterogeneous group in both the catheterization and chronic retention groups. If someone has an elevated residual of over 500 ccs, many practitioners would recommend that they use a catheter, while many would not. So it's hard to assess the granularity between those groups. But what we did find is that men with chronic retention seem to pass their trial without a catheter just as quickly as those who had low post void residuals.
The way that that's changed our practice is we've began leaving catheters in for a little bit longer in men who either used intermittent catheterization or had an indwelling catheter prior to surgery. We leave it closer to a week. The mean number of days for men to pass their trial without a catheter for those who had a history of acute retention was 14 days compared to only 7 days with chronic retention and 4 days for those who had no urinary retention.
This transcription has been edited for clarity.