TY - JOUR
T1 - Variation in catheter management and predictors of trial without catheter success in men with AUR
T2 - results from the AUR-SNAPSHOT study
AU - Merode, Nadine Arina Maria Van
AU - Hermans, P. Y.
AU - De Jong, T.
AU - Schout, B. M. A.
AU - Cobussen, C.
AU - Van Basten, J. P. A.
AU - De Jongh, R.
AU - Mekke, S.
AU - Roshani, H.
AU - Nijenhuis, M. M.
AU - Van Uhm, J. I. M.
AU - Kikkert, R. R.
AU - Tilli, S.
AU - Heesakkers, J. F. A.
AU - Duijn, M.
AU - Van Haarst, E. P.
AU - Tijans, A. M.
AU - Noordzij, A.
AU - Van Eerten-Koops, L.
AU - Bleumer, I.
AU - Tijhof, E. H.
AU - Cornel, E. B.
AU - Witte, L. P. W.
PY - 2025/12/1
Y1 - 2025/12/1
N2 - Background and objective This study aimed to assess practice variation in the timing and management of trial without catheter (TWOC) following acute urinary retention (AUR) in Dutch hospitals. Secondary objectives were to identify clinical predictors of TWOC success and evaluate catheter-related complications. Methods We conducted a retrospective cross-sectional observational study across multiple Dutch hospitals. Male patients aged >= 18 years with a single episode of spontaneous AUR were identified using electronic health record queries. Data collected included catheter duration, alpha-blocker use, TWOC outcomes, predictors of success, and complications. TWOC success was defined as spontaneous voiding with acceptable post-void residual, as judged by the local clinician. Predictors were determined with multivariable binomial logistic regression. Key findings and limitations A total of 299 men (mean age 73.1 +/- 9.4 years) were included from January 2022 to June 2022. Median drained volume was 1000 mL (IQR 750-1500 mL), and median catheter duration was 15 days (IQR 6-23 days). TWOC success varied across hospitals (14-55 %). Catheter duration and alpha-blocker were not significant predictors. Older age (OR 0.93, p = 0.001) and larger drained volume (OR 0.99, p < 0.001) were associated with lower success, while alcohol consumption increased success odds (OR 3.54, p = 0.016). The study is limited by the retrospective design, lack of standard definition for TWOC success, and observational nature. Conclusion Substantial variation exists in catheter duration and TWOC management across Dutch hospitals. Age, drained volume, and alcohol use were significant predictors of TWOC outcome. However, the association with alcohol should be interpreted as an indication that non-BOO causes of AUR may resolve spontaneously. Findings highlight the need for standardised protocols and support future multicenter randomized trials to optimize care, reduce complications, and improve patient quality of life.
AB - Background and objective This study aimed to assess practice variation in the timing and management of trial without catheter (TWOC) following acute urinary retention (AUR) in Dutch hospitals. Secondary objectives were to identify clinical predictors of TWOC success and evaluate catheter-related complications. Methods We conducted a retrospective cross-sectional observational study across multiple Dutch hospitals. Male patients aged >= 18 years with a single episode of spontaneous AUR were identified using electronic health record queries. Data collected included catheter duration, alpha-blocker use, TWOC outcomes, predictors of success, and complications. TWOC success was defined as spontaneous voiding with acceptable post-void residual, as judged by the local clinician. Predictors were determined with multivariable binomial logistic regression. Key findings and limitations A total of 299 men (mean age 73.1 +/- 9.4 years) were included from January 2022 to June 2022. Median drained volume was 1000 mL (IQR 750-1500 mL), and median catheter duration was 15 days (IQR 6-23 days). TWOC success varied across hospitals (14-55 %). Catheter duration and alpha-blocker were not significant predictors. Older age (OR 0.93, p = 0.001) and larger drained volume (OR 0.99, p < 0.001) were associated with lower success, while alcohol consumption increased success odds (OR 3.54, p = 0.016). The study is limited by the retrospective design, lack of standard definition for TWOC success, and observational nature. Conclusion Substantial variation exists in catheter duration and TWOC management across Dutch hospitals. Age, drained volume, and alcohol use were significant predictors of TWOC outcome. However, the association with alcohol should be interpreted as an indication that non-BOO causes of AUR may resolve spontaneously. Findings highlight the need for standardised protocols and support future multicenter randomized trials to optimize care, reduce complications, and improve patient quality of life.
KW - Acute urinary retention
KW - Lower urinary tract symptoms
KW - Trial without catheter
KW - Catheter duration
KW - Predictors
KW - Alpha-blocker
KW - ACUTE URINARY RETENTION
U2 - 10.1016/j.cont.2025.102295
DO - 10.1016/j.cont.2025.102295
M3 - Article
SN - 2772-9737
VL - 16
JO - Continence
JF - Continence
M1 - 102295
ER -