It is important when managing patients with UR associated with BPH that the following points are carefully taken into consideration.
1. Perform DRE to make or confirm diagnosis and exclude malignancy and infection.
2. Measure residual urine prior to catheterization if UTI is suspected.
3. Measure serum creatinine to ensure high-pressure chronic retention is not overlooked, and if present monitor, treat diuresis appropriately, and ensure definitive bladder drainage is in place either via surgery or catheterization.
4. TURP is still appropriate as first-line management of AUR for between 20 % and 40 % of patients, either acutely or electively.
5. Many patients failing TWOC are not suitable for surgical treatment due to high-risk co-morbidity, and many of these can safely be managed with long-term catheterization, either urethral or supra-pubic according to choice and suitability
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