Urinary retention after endovascular treatment for aortic aneurysm: A single hospital experience

Wei Ming Cheng, Yi Hsiu Huang, Allen W. Chiu, Chun Che Shih, Yen Hwa Chang, Alex T.L. Lin, Kuang Kuo Chen

Research output: Contribution to journalArticle

Abstract

Objective After endovascular aortic repair (EVAR) for aortic aneurysm, some patients may develop urinary retention that may be vasogenic or neurogenic. This single-institution study investigated the characteristics of patients who developed urinary retention after EVAR for aortic aneurysm. Materials and Methods Patients with thoracic or abdominal aortic aneurysms and who underwent EVAR between November 2005 and October 2012 were reviewed. Those with post-operative urinary retention requiring urodynamic evaluation with filling cystometry (CMG) were identified. Their characteristics, surgical details, and urodynamic findings were collected for analysis. Results During the study period, 736 patients received endovascular treatment. Ten patients (nine males and one female; mean age at surgery, 71 ± 15.0 years) developed post-operative urinary retention, for an incidence rate of 1.36%. Two had co-morbid benign prostatic obstruction but all had aneurysm involving the thoracic aorta, with the largest mean aneurysm diameter at 64.8 ± 22.6 mm. All of the distal landing zones were above the celiac trunk and without occlusion of the blood supply to the urinary bladder. Seven patients had cerebrovascular complications or spinal cord ischemia. The CMG done within three months showed detrusor normoreflexia or over-activity in five, poor compliance of the urinary bladder in three, and acontractile detrusor in two patients. Those with acontractile detrusor had detrusor over-activity on follow-up CMG. Eight had successful decatheterization, while two with poor compliance of the urinary bladder needed long-term catheterization. The mean urethral catheter retention duration was 51.4 ± 33.1 days. Conclusions Urinary retention is a rare complication after EVAR for thoracic aortic aneurysm. Spinal cord ischemia or cerebrovascular complications may be contributory.

Original languageEnglish
Pages (from-to)180-185
Number of pages6
JournalUrological Science
Volume28
Issue number3
DOIs
Publication statusPublished - Sep 1 2017
Externally publishedYes

Fingerprint

Urinary Retention
Aortic Aneurysm
Spinal Cord Ischemia
Thoracic Aortic Aneurysm
Urinary Bladder
Urodynamics
Therapeutics
Aneurysm
Urinary Catheters
Abdominal Aortic Aneurysm
Thoracic Aorta
Catheterization
Abdomen
Incidence

Keywords

  • aortic aneurysm
  • endovascular treatment
  • spinal cord ischemia
  • urinary retention

ASJC Scopus subject areas

  • Urology

Cite this

Urinary retention after endovascular treatment for aortic aneurysm : A single hospital experience. / Cheng, Wei Ming; Huang, Yi Hsiu; Chiu, Allen W.; Shih, Chun Che; Chang, Yen Hwa; Lin, Alex T.L.; Chen, Kuang Kuo.

In: Urological Science, Vol. 28, No. 3, 01.09.2017, p. 180-185.

Research output: Contribution to journalArticle

Cheng, Wei Ming ; Huang, Yi Hsiu ; Chiu, Allen W. ; Shih, Chun Che ; Chang, Yen Hwa ; Lin, Alex T.L. ; Chen, Kuang Kuo. / Urinary retention after endovascular treatment for aortic aneurysm : A single hospital experience. In: Urological Science. 2017 ; Vol. 28, No. 3. pp. 180-185.
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abstract = "Objective After endovascular aortic repair (EVAR) for aortic aneurysm, some patients may develop urinary retention that may be vasogenic or neurogenic. This single-institution study investigated the characteristics of patients who developed urinary retention after EVAR for aortic aneurysm. Materials and Methods Patients with thoracic or abdominal aortic aneurysms and who underwent EVAR between November 2005 and October 2012 were reviewed. Those with post-operative urinary retention requiring urodynamic evaluation with filling cystometry (CMG) were identified. Their characteristics, surgical details, and urodynamic findings were collected for analysis. Results During the study period, 736 patients received endovascular treatment. Ten patients (nine males and one female; mean age at surgery, 71 ± 15.0 years) developed post-operative urinary retention, for an incidence rate of 1.36{\%}. Two had co-morbid benign prostatic obstruction but all had aneurysm involving the thoracic aorta, with the largest mean aneurysm diameter at 64.8 ± 22.6 mm. All of the distal landing zones were above the celiac trunk and without occlusion of the blood supply to the urinary bladder. Seven patients had cerebrovascular complications or spinal cord ischemia. The CMG done within three months showed detrusor normoreflexia or over-activity in five, poor compliance of the urinary bladder in three, and acontractile detrusor in two patients. Those with acontractile detrusor had detrusor over-activity on follow-up CMG. Eight had successful decatheterization, while two with poor compliance of the urinary bladder needed long-term catheterization. The mean urethral catheter retention duration was 51.4 ± 33.1 days. Conclusions Urinary retention is a rare complication after EVAR for thoracic aortic aneurysm. Spinal cord ischemia or cerebrovascular complications may be contributory.",
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T2 - A single hospital experience

AU - Cheng, Wei Ming

AU - Huang, Yi Hsiu

AU - Chiu, Allen W.

AU - Shih, Chun Che

AU - Chang, Yen Hwa

AU - Lin, Alex T.L.

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N2 - Objective After endovascular aortic repair (EVAR) for aortic aneurysm, some patients may develop urinary retention that may be vasogenic or neurogenic. This single-institution study investigated the characteristics of patients who developed urinary retention after EVAR for aortic aneurysm. Materials and Methods Patients with thoracic or abdominal aortic aneurysms and who underwent EVAR between November 2005 and October 2012 were reviewed. Those with post-operative urinary retention requiring urodynamic evaluation with filling cystometry (CMG) were identified. Their characteristics, surgical details, and urodynamic findings were collected for analysis. Results During the study period, 736 patients received endovascular treatment. Ten patients (nine males and one female; mean age at surgery, 71 ± 15.0 years) developed post-operative urinary retention, for an incidence rate of 1.36%. Two had co-morbid benign prostatic obstruction but all had aneurysm involving the thoracic aorta, with the largest mean aneurysm diameter at 64.8 ± 22.6 mm. All of the distal landing zones were above the celiac trunk and without occlusion of the blood supply to the urinary bladder. Seven patients had cerebrovascular complications or spinal cord ischemia. The CMG done within three months showed detrusor normoreflexia or over-activity in five, poor compliance of the urinary bladder in three, and acontractile detrusor in two patients. Those with acontractile detrusor had detrusor over-activity on follow-up CMG. Eight had successful decatheterization, while two with poor compliance of the urinary bladder needed long-term catheterization. The mean urethral catheter retention duration was 51.4 ± 33.1 days. Conclusions Urinary retention is a rare complication after EVAR for thoracic aortic aneurysm. Spinal cord ischemia or cerebrovascular complications may be contributory.

AB - Objective After endovascular aortic repair (EVAR) for aortic aneurysm, some patients may develop urinary retention that may be vasogenic or neurogenic. This single-institution study investigated the characteristics of patients who developed urinary retention after EVAR for aortic aneurysm. Materials and Methods Patients with thoracic or abdominal aortic aneurysms and who underwent EVAR between November 2005 and October 2012 were reviewed. Those with post-operative urinary retention requiring urodynamic evaluation with filling cystometry (CMG) were identified. Their characteristics, surgical details, and urodynamic findings were collected for analysis. Results During the study period, 736 patients received endovascular treatment. Ten patients (nine males and one female; mean age at surgery, 71 ± 15.0 years) developed post-operative urinary retention, for an incidence rate of 1.36%. Two had co-morbid benign prostatic obstruction but all had aneurysm involving the thoracic aorta, with the largest mean aneurysm diameter at 64.8 ± 22.6 mm. All of the distal landing zones were above the celiac trunk and without occlusion of the blood supply to the urinary bladder. Seven patients had cerebrovascular complications or spinal cord ischemia. The CMG done within three months showed detrusor normoreflexia or over-activity in five, poor compliance of the urinary bladder in three, and acontractile detrusor in two patients. Those with acontractile detrusor had detrusor over-activity on follow-up CMG. Eight had successful decatheterization, while two with poor compliance of the urinary bladder needed long-term catheterization. The mean urethral catheter retention duration was 51.4 ± 33.1 days. Conclusions Urinary retention is a rare complication after EVAR for thoracic aortic aneurysm. Spinal cord ischemia or cerebrovascular complications may be contributory.

KW - aortic aneurysm

KW - endovascular treatment

KW - spinal cord ischemia

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