Multivariate Analysis of the Failure of Removal of the Urinary Catheter within 48 Hours after Transurethral Enucleation and Resection of the Prostate

Abstract

Objective. To assess the value of clinically relevant data for predicting the failure of removal of the urinary catheter within 48 hours after TUERP. Materials and Methods. We retrospectively analyzed the medical records of 357 patients who underwent TUERP between January 2015 and July 2018, all of whom stopped bladder irrigation and removed urinary catheter within 48 hours after the operation. According to whether the removal of the catheter was successful, the patients were classified into 2 groups: Group A was successful and group B was a failure. Univariate analysis was performed to determine the association between the failure of removal of the catheter and the patients’ preoperative clinical characteristics. Logistic regression analysis and receiver operating characteristic analysis (ROC) were conducted to establish the prediction model. Then the area under the curve (AUC) and the cut-off value were calculated. Results. 357 patients were divided into group A (n = 305, 85.4%) and group B (n = 52, 14.6%). The patients’ drug medication (P=0.006), history of acute urinary retention (AUR) (P≤0.001), smoke (P=0.045), IPSS (P≤0.001), IPP (P=0.006), PSA (P=0.047), residual urine volume (P≤0.001), QoL (P≤0.001), and TPV (P=0.043) were significantly different between the 2 groups. A predictive model using logistic regression was defined as follows: INDEX = 10.862–1.376 × (IPSS) − 1.185 × (QoL) − 1.062 × (drug medication) + 1.079 × (history of AUR) + 0.030 × (TPV) − 0.867 × (IPP) with area under the curve of 0.860 obtained from the ROC curve analysis. The predictive model had a cut-off value of 1.7725, and the sensitivity for predicting the failure of removal of the urethra was 74.1% and the specificity was 84.6%. Conclusion. This study demonstrated that IPSS, QoL, drug medication, history of AUR, TPV, and IPP are independent factors associated with the failure of removal of the urethral catheter within 48 hours after TUERP.