Clinical benefits of retrograde bladder filling method prior to catheter removal after TURP for BPH: A prospective randomized trial

Purpose: To evaluate possible benefits and clinical feasibility of retrograde bladder filling method prior to intravesical catheter removal after transurethral prostatectomy (TURP) for benign prostatic hyperplasia (BPH). Materials and Methods: Male patients undergoing TURP for BPH from January 2019 to October 2019 were randomized in a 1:1 ratio into either retrograde filling (RF) or spontaneous voiding (SV) methods at a single institution to determine safety and efficacy of RF (NCT04309032), with surgeons blinded to allocation. Perioperative outcomes including postoperative complications were compared between two groups. Clinician/patients’ satisfaction level which was evaluated with postoperative questionnaires were also compared. Results: A total of 56 patients were randomized into two groups and 56 were included in final analysis (28 men in RF group, 26 in SV group). No significant differences in baseline characteristics including age, prostate volume, or perioperative uroflowmetry were observed. However, RF significantly facilitated time to void (67.0±63.2 vs. 144.0±78.7 min; p<0.001) and time to discharge (168.4±57.2 vs. 218.9±106.9 min; p=0.046). Immediate postoperative complications were comparable in both methods with no significant difference. Overall patient and medical staff satisfaction showed tolerable and similar response by either procedure. Conclusions: RF method for intravesical catheter removal is a safe and satisfactory method that can facilitate early voiding detection and shorten the time to discharge. Further trials are required to further validate our results.