The Resource Chronic urinary retention : comparative effectiveness and harms of treatments, prepared by Minnesota Evidence-based Practice Center ; investigators, Michelle Brasure, Howard A. Fink, Michael Risk, Roderick MacDonald, Tatyana Shamliyan, Jeannine Ouellette, Dongjuan Xu, Mary Butler, Robert L. Kane, Timothy J. Wilt

Chronic urinary retention : comparative effectiveness and harms of treatments, prepared by Minnesota Evidence-based Practice Center ; investigators, Michelle Brasure, Howard A. Fink, Michael Risk, Roderick MacDonald, Tatyana Shamliyan, Jeannine Ouellette, Dongjuan Xu, Mary Butler, Robert L. Kane, Timothy J. Wilt

Label
Chronic urinary retention : comparative effectiveness and harms of treatments
Title
Chronic urinary retention
Title remainder
comparative effectiveness and harms of treatments
Statement of responsibility
prepared by Minnesota Evidence-based Practice Center ; investigators, Michelle Brasure, Howard A. Fink, Michael Risk, Roderick MacDonald, Tatyana Shamliyan, Jeannine Ouellette, Dongjuan Xu, Mary Butler, Robert L. Kane, Timothy J. Wilt
Title variation
Effective Health Care Program
Creator
Contributor
Author
Issuing body
Sponsoring body
Subject
Genre
Language
eng
Summary
OBJECTIVE: To determine the effectiveness and comparative effectiveness of treatments for chronic urinary retention (CUR), also termed partial or persistent urinary retention or incomplete bladder emptying, in adults. DATA SOURCES: Ovid MEDLINE(r) and the Cochrane Central Register of Controlled Trials bibliographic databases; hand searches of references of relevant studies. REVIEW METHODS: Two investigators screened abstracts and full-text articles of identified references for eligibility. Eligible studies included randomized controlled trials and prospective cohort studies enrolling patients with CUR. Primary outcomes included rate of urinary tract infections, urinary symptom or quality-of-life score category, and successful trial without catheter. Intermediate outcomes included postvoid residual (PVR) urine volume and continuous measures of urinary symptoms or quality of life. We extracted data, assessed risk of bias on individual studies, and evaluated strength of evidence for each comparison and outcome. RESULTS: We identified 11 publications reporting original research and 2 relevant systematic reviews that met eligibility criteria. Results are analyzed by etiology: obstructive, nonobstructive, and mixed populations/unknown causes. Only three studies addressed obstructive causes of CUR; all studied men with bladder outlet obstruction due to benign prostatic enlargement. Low-strength evidence suggested that transurethral resection of the prostate and microwave therapy achieved similar improvements in the rates of successful trial without catheter at 6 months posttreatment. Evidence was insufficient to draw conclusions regarding other outcomes because estimates were imprecise, risk of bias was moderate, and consistency could not be evaluated. Evidence for other treatment comparisons for CUR from obstructive causes was insufficient to conclude that one treatment was more effective than the comparison. Four small studies and one systematic review assessed treatments for CUR from nonobstructive causes. A previous systematic review provided low-strength evidence that neuromodulation improves the rate at which patients with Fowler's syndrome can be catheter free after treatment. Low-strength evidence suggested that botulinum toxin injected into the urethral sphincter may not improve PVR volumes. Two studies and one systematic review addressed CUR treatments in mixed populations or CUR from unknown causes. Evidence from original research was insufficient to conclude that one treatment was any more or less effective than another. Evidence on harms was inconsistently reported across all interventions, and no differences were detected across treatment groups; however, studies were not adequately powered to detect differences in harms across groups. CONCLUSIONS: We identified few studies; most were small and had methodological flaws. Evidence was insufficient due to risk of bias and imprecision, and we were not able to evaluate consistency of results across studies. Further research should address conceptual issues in studying CUR as well as strengthening the evidence base with adequately powered controlled trials or prospective cohort studies for populations and interventions common in practice
Member of
Cataloging source
DNLM
http://library.link/vocab/creatorName
Brasure, Michelle
Funding information
Prepared for the Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services by the Minnesota Evidence-based Practice Center
Government publication
federal national government publication
Illustrations
illustrations
Index
no index present
Literary form
non fiction
Nature of contents
  • dictionaries
  • surveys of literature
NLM call number
WJ 146
http://library.link/vocab/relatedWorkOrContributorName
  • Minnesota Evidence-based Practice Center
  • United States
  • Effective Health Care Program (U.S.)
Series statement
  • Comparative effectiveness review
  • AHRQ publication
Series volume
  • number 140
  • no. 14-EHC041-EF
http://library.link/vocab/subjectName
  • Urinary Retention
  • Chronic Disease
  • Comparative Effectiveness Research
  • Treatment Outcome
http://bibfra.me/vocab/relation/supportingbody
SGEpYsXqBGk
Label
Chronic urinary retention : comparative effectiveness and harms of treatments, prepared by Minnesota Evidence-based Practice Center ; investigators, Michelle Brasure, Howard A. Fink, Michael Risk, Roderick MacDonald, Tatyana Shamliyan, Jeannine Ouellette, Dongjuan Xu, Mary Butler, Robert L. Kane, Timothy J. Wilt
Instantiates
Publication
Note
"September 2014."
Bibliography note
Includes bibliographical references
Carrier category
online resource
Carrier category code
cr
Carrier MARC source
rdacarrier
Color
black and white
Content category
text
Content type code
txt
Content type MARC source
rdacontent
Control code
902835075
Dimensions
unknown
Extent
1 online resource (1 PDF file (various pagings))
Form of item
online
Media category
computer
Media MARC source
rdamedia
Media type code
c
Other physical details
illustrations.
Specific material designation
remote
System control number
(OCoLC)902835075
Label
Chronic urinary retention : comparative effectiveness and harms of treatments, prepared by Minnesota Evidence-based Practice Center ; investigators, Michelle Brasure, Howard A. Fink, Michael Risk, Roderick MacDonald, Tatyana Shamliyan, Jeannine Ouellette, Dongjuan Xu, Mary Butler, Robert L. Kane, Timothy J. Wilt
Publication
Note
"September 2014."
Bibliography note
Includes bibliographical references
Carrier category
online resource
Carrier category code
cr
Carrier MARC source
rdacarrier
Color
black and white
Content category
text
Content type code
txt
Content type MARC source
rdacontent
Control code
902835075
Dimensions
unknown
Extent
1 online resource (1 PDF file (various pagings))
Form of item
online
Media category
computer
Media MARC source
rdamedia
Media type code
c
Other physical details
illustrations.
Specific material designation
remote
System control number
(OCoLC)902835075

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