The Effect and Safety of Rapid and Gradual Urinary Decompression in Urine Retention: A Systematic Review and Meta-Analysis
<i>Background and objectives:</i> Trials to evaluate the effect and safety of rapid and gradual urinary decompression have been published for decades. Due to inconclusive results, this study aimed to assess whether rapid bladder decompression increased complications in adults with acute...
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| Format: | Article |
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MDPI AG
2022-10-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1648-9144/58/10/1441 |
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| author | Meng-Yu Wu Jer-Ruey Chang Yi-Kung Lee Po-Chen Lin Tou-Yuan Tsai |
| author_facet | Meng-Yu Wu Jer-Ruey Chang Yi-Kung Lee Po-Chen Lin Tou-Yuan Tsai |
| author_sort | Meng-Yu Wu |
| collection | DOAJ |
| description | <i>Background and objectives:</i> Trials to evaluate the effect and safety of rapid and gradual urinary decompression have been published for decades. Due to inconclusive results, this study aimed to assess whether rapid bladder decompression increased complications in adults with acute urinary retention. <i>Materials and Methods:</i> We searched the <i>Cochrane Library</i>, <i>EMBASE</i>, <i>Google Scholar,</i> and <i>PubMed</i> databases for articles published from the database inception to 31 August 2021. Studies that compared the effects and complication rates of rapid and gradual urinary decompression in adults with acute urinary retention were included. The primary outcome was post-decompression hematuria, while the secondary outcome was circulatory collapse. Meta-analyses were conducted using random effects models. Sensitivity analyses, tests for publication bias, and trial sequential analyses were conducted. The PROSPERO registration number is CRD42021233457. <i>Results:</i> Overall, four articles were included in the comprehensive analysis, and 435 participants met all the eligibility criteria. In the primary meta-analysis of all four study groups, rapid urinary decompression did not increase the risk of post-decompression hematuria (RR = 0.91; 95% CI: 0.62 to 1.35; <i>p</i> = 0.642). The <i>I</i><sup>2</sup> statistic was 0.0% (<i>p</i> = 0.732), indicating no substantial heterogeneity. In the meta-analysis of randomized controlled studies, the result did not change (RR = 0.89; 95% CI: 0.31 to 2.52; <i>p</i> = 0.824). The Egger’s test and Begg test (<i>p</i> = 0.339 and 0.497, respectively) indicated the absence of statistical evidence of publication bias. Leave-one-out sensitivity analysis was conducted and showed the pooled results were robust. In secondary outcome, there were no reported events of circulatory collapse in the current studies. <i>Conclusions:</i> The currently available data suggest that rapid urinary decompression is an effective and safe method with a complication rate similar to that of gradual decompression in an acute urinary retention population. Further large-scale randomized studies are required. |
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| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-03-09T19:51:19Z |
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| spelling | doaj.art-8bf33b612bb949e8bf380a1b7d38d6b32023-11-24T01:11:12ZengMDPI AGMedicina1010-660X1648-91442022-10-015810144110.3390/medicina58101441The Effect and Safety of Rapid and Gradual Urinary Decompression in Urine Retention: A Systematic Review and Meta-AnalysisMeng-Yu Wu0Jer-Ruey Chang1Yi-Kung Lee2Po-Chen Lin3Tou-Yuan Tsai4Department of Emergency Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City 231, TaiwanEmergency Department, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, 622, TaiwanSchool of Medicine, Tzu Chi University, Hualien 970, TaiwanDepartment of Emergency Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City 231, TaiwanSchool of Medicine, Tzu Chi University, Hualien 970, Taiwan<i>Background and objectives:</i> Trials to evaluate the effect and safety of rapid and gradual urinary decompression have been published for decades. Due to inconclusive results, this study aimed to assess whether rapid bladder decompression increased complications in adults with acute urinary retention. <i>Materials and Methods:</i> We searched the <i>Cochrane Library</i>, <i>EMBASE</i>, <i>Google Scholar,</i> and <i>PubMed</i> databases for articles published from the database inception to 31 August 2021. Studies that compared the effects and complication rates of rapid and gradual urinary decompression in adults with acute urinary retention were included. The primary outcome was post-decompression hematuria, while the secondary outcome was circulatory collapse. Meta-analyses were conducted using random effects models. Sensitivity analyses, tests for publication bias, and trial sequential analyses were conducted. The PROSPERO registration number is CRD42021233457. <i>Results:</i> Overall, four articles were included in the comprehensive analysis, and 435 participants met all the eligibility criteria. In the primary meta-analysis of all four study groups, rapid urinary decompression did not increase the risk of post-decompression hematuria (RR = 0.91; 95% CI: 0.62 to 1.35; <i>p</i> = 0.642). The <i>I</i><sup>2</sup> statistic was 0.0% (<i>p</i> = 0.732), indicating no substantial heterogeneity. In the meta-analysis of randomized controlled studies, the result did not change (RR = 0.89; 95% CI: 0.31 to 2.52; <i>p</i> = 0.824). The Egger’s test and Begg test (<i>p</i> = 0.339 and 0.497, respectively) indicated the absence of statistical evidence of publication bias. Leave-one-out sensitivity analysis was conducted and showed the pooled results were robust. In secondary outcome, there were no reported events of circulatory collapse in the current studies. <i>Conclusions:</i> The currently available data suggest that rapid urinary decompression is an effective and safe method with a complication rate similar to that of gradual decompression in an acute urinary retention population. Further large-scale randomized studies are required.https://www.mdpi.com/1648-9144/58/10/1441acute urinary retentionrapid decompressionhematuriacirculatory collapse |
| spellingShingle | Meng-Yu Wu Jer-Ruey Chang Yi-Kung Lee Po-Chen Lin Tou-Yuan Tsai The Effect and Safety of Rapid and Gradual Urinary Decompression in Urine Retention: A Systematic Review and Meta-Analysis Medicina acute urinary retention rapid decompression hematuria circulatory collapse |
| title | The Effect and Safety of Rapid and Gradual Urinary Decompression in Urine Retention: A Systematic Review and Meta-Analysis |
| title_full | The Effect and Safety of Rapid and Gradual Urinary Decompression in Urine Retention: A Systematic Review and Meta-Analysis |
| title_fullStr | The Effect and Safety of Rapid and Gradual Urinary Decompression in Urine Retention: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | The Effect and Safety of Rapid and Gradual Urinary Decompression in Urine Retention: A Systematic Review and Meta-Analysis |
| title_short | The Effect and Safety of Rapid and Gradual Urinary Decompression in Urine Retention: A Systematic Review and Meta-Analysis |
| title_sort | effect and safety of rapid and gradual urinary decompression in urine retention a systematic review and meta analysis |
| topic | acute urinary retention rapid decompression hematuria circulatory collapse |
| url | https://www.mdpi.com/1648-9144/58/10/1441 |
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