Patients with acute and chronic urinary retention, scheduled for benign prostatic hyperplasia surgery, often need bladder decompression in order to restore detrusor contractility. Suprapubic catheter or indwelling catheterization are widely used for this purpose and have their own disadvantages and complications. IC is well known method of bladder decompression for patients with neurogenic hypocontractile bladder. It' The possibilities of intermittent catheterization (IC) for preoperative bladder decompression for patients with BOO and urinary retention is to be studied.

63 male patients were divided into 2 groups. All patients had urinary retention more than 250 cc - 17 patients (27%) had acute retention with negative trial without catheter, 46 patients (73%) with chronic retention. 37 patients (Group 1) underwent suprapubic cystostomy, 26 patients ((group 2) who were taught intermittent catheterisation. The median age was 63.5 years, the median prostate volume was 83.18 cm3. Patients in both groups received α-adrenergic blockers, NSAIDs. Patients with suprapubic catheter were taught to close the drain regularly till the voiding desire.  All patients filled in bladder diaries and signed the urination volume and the residual volume (excreted by IC or cystostome). Besides the common the diagnostics work-up included invasive urodynamic study (before the treatment – cystometry, then every 10 days - pressure-flow study). The mean detrusor contractility index before the start of therapy was 67 ± 13.

in both groups there was a decrease in the maximal bladder capacity: on the 10th day in the group 1 by 12%, and in group 2 by 18% (p˂0.05). In the IC group complete bladder emptying on the 30th day of therapy was achieved in 78% of patients, while in the suprapubic catheter group in 73% of patients (p> 0.05). In the IC group a residual volume reduction to the goal “less than 10% of voiding volume” was achieved by 23 ± 9 days. The number of infectious complications in group 1 was 4%, in group 2 -  2% (p> 0.05).In IC group 12 patients (46%) experienced moderate discomfort during self-catheherisation because of BOO.

IC can be as effective as suprapubic catheter in the preoperative management for patients with bladder outlet obstruction and urinary obstruction. It was shown, that restoration of detrusor contractility can be achieved earlier with the IC that with suprapubic catheter. IC was not associated with higher complications rate.

IC is safe and effective alternative of urine diversion for preoperative drainage of the urinary bladder for patients with bladder outlet obstruction with urinary retention.