Vol. 42 (6): 1202-1209, November – December, 2016
Rate of spontaneous voiding recovery after acute urinary retention due to bed rest in the hospital setting in a nonurological population clinical study of the relationship between lower limbs and bladder function
Paulo Rodrigues 1,2, Flávio Hering 1,2, Eli Cieli 1, Joao Carlos Campagnari 1
1 Clínica de Urologia do Hospital Beneficência Portuguesa de São Paulo – São Paulo, Brasil; 2 Departamento de Urologia, Hospital Santa Helena de São Paulo – São Paulo, Brasil
Objectives: To understand the clinical relationship between lower limbs functions and the recovery of spontaneous voiding after an acute urinary retention (AUR) in older patients admitted to hospitals for non-urological causes using clinical parameters.
Materials and Methods: 56 adult patients (32 men; mean age: 77.9 ± 8.3 and 24 women; mean age 82.1 ± 4.6) with AUR were prospectively followed with validated Physical Performance Mobility Exam (PPME) instrument to evaluate the relationship between the recovery of mobility capacity and spontaneous voiding. After a short period of permanent bladder drainage patients started CIC along evaluation by PPME during hospitalization and at 7, 15, 30 60, 90, and 180 days of discharge. Mann-Whitney U, chi-square test and ANOVA tests were used.
Results: All patients were hospitalized for at least 15 days (Median 26.3 ± 4.1 days).
Progressive improvement on mobility scale measured by PPME was observed after leaving ICU and along the initial 7 days of hospitalization but with a deterioration if hospitalization extends beyond 15 days (p<0.03). Prolonged hospital stay impairs mobility in all domains (p<0.05) except step-up and transfer skills (p<0.02) although a recovery rate on spontaneous voiding persistented. Restoration of spontaneous voiding was accompanied by improvement on mobility scale (p<0.02). Recovery of spontaneous voiding was markedly observed after discharging the hospital. All patients recovered spontaneous voiding until 6 months of follow-up.
Conclusions: Recovery to spontaneous voiding after acute urinary retention in the hospital setting may be anticipated by evaluation of lower limbs function measured by validated instruments.
Keywords: Urinary Retention; Clinical Study [Publication Type]; Urinary Bladder; Urinary Incontinence; Catheterization