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A retrospective single-center study analyzed 327 men treated between 2018 and 2024 to determine clinical and urodynamic predictors of initial TWOC failure. Multivariate logistic regression identified detrusor underactivity and low bladder outlet obstruction as independent risk factors. Patients with both showed substantially higher failure likelihood, while high BOO with preserved detrusor function indicated lower risk even with elevated preoperative PVR.",{"@graph":69,"@context":127},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/predicting-initial-trial-without-catheter-failure-after-prostate-deobstruction-surgery-using-preoperative-urodynamics/459910/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/predicting-initial-trial-without-catheter-failure-after-prostate-deobstruction-surgery-using-preoperative-urodynamics/459910.png","ImageObject",300,407,{"name":92,"@type":93},"McQueen","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-31","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",11,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119,123],{"name":110,"@type":111,"acceptedAnswer":112},"What outcome defines initial TWOC failure in this study?","Question",{"text":113,"@type":114},"Initial TWOC failure was defined as requiring recatheterization within 1 week after catheter removal.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"Which preoperative urodynamic factors predicted initial TWOC failure?",{"text":118,"@type":114},"The study found detrusor underactivity and low bladder outlet obstruction as independent predictors of initial TWOC failure.",{"name":120,"@type":111,"acceptedAnswer":121},"Can TWOC be attempted early for patients with high BOO and preserved detrusor function?",{"text":122,"@type":114},"Yes. Patients with high BOO and preserved detrusor contractility demonstrated lower TWOC failure risk even when preoperative postvoid residual volume was elevated (PVR ≥ 300 mL).",{"name":124,"@type":111,"acceptedAnswer":125},"How should postoperative catheter management be individualized based on the findings?",{"text":126,"@type":114},"Preoperative multichannel urodynamics enable risk stratification. Patients with detrusor underactivity and low BOO may benefit from prolonged catheterization, whereas selected patients with high BOO and preserved detrusor function may be suitable for earlier catheter removal.","https://schema.org",{"og:url":83,"og:type":129,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":131,"canonical":83},"index,follow",{"doc_id":133,"site_id":62},459910,1790961068,{"code":4,"msg":5,"data":136},{"doc_id":133,"user_id":137,"nickname":92,"user_avatar":138,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":139,"file_id":140,"file_url":141,"file_type":142,"file_size":143,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":144,"language":145,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":146,"faqs":147,"seo_title":148,"seo_description":67,"update_tm":149,"read_time":41,"preview_page_count":4},5909890329169,"https://ap-avatar.wpscdn.com/davatar_9964176cb1d06d4a9deccf72a44ae3dc","Original Article  \nInt Neurourol J 2025;29(4):286-295  \n[https://doi.org/10.5213/inj.2550176.088](https://doi.org/10.5213/inj.2550176.088)[ ](https://doi.org/10.5213/inj.2550176.088)pISSN 2093-4777 · eISSN 2093-6931  \nPredicting Initial Trial Without Catheter Failure After Prostate Deobstruction Surgery Using Preoperative Urodynamics  \nJen-Hao Kuo1,*, Ming-Syun Chuang1,*, Hau-Chern Jan1, Yu-Sheng Cheng1, Yi‐Hui Ho2, Yao-Lin Kao1, Kuen-Jer Tsai3,4, Yin-Chien Ou1  \n1Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan 2Department of Anesthesiology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan 3Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan  \n4Research Center of Clinical Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan  \nPurpose: Prostate deobstruction surgery is effective for relieving lower urinary tract symptoms in men with benign prostatic obstruction, yet some patients experience failure of the initial trial without catheter (TWOC) postoperatively and require recatheterization. This study aimed to identify clinical and urodynamic predictors of initial TWOC failure after prostate deobstruction surgery.  \nMethods: A retrospective single-center study was conducted on 327 men who underwent prostate deobstruction surgery, including transurethral resection of the prostate, GreenLight laser photoselective vaporization, and holmium laser enucleation, at our institution from 2018 to 2024. Clinical characteristics, prostate volume, preoperative and postoperative uroflowmetry, and multichannel urodynamic parameters were evaluated. Initial TWOC failure was defined as recatheterization within 1 week of catheter removal. Logistic regression analysis was performed to identify predictive factors.  \nResults: Among the 327 patients, 41 (12.5%) experienced initial TWOC failure. Uroflowmetry parameters improved significantly postoperatively. Multivariate analysis identified detrusor underactivity (DU) (odds ratio [OR], 2.773; P = 0.012) and low bladder outlet obstruction (BOO) (OR, 2.881; P = 0.041) as independent predictors. Patients with both risk factors exhibited a higher likelihood of initial TWOC failure (OR, 4.560; P = 0.003), whereas those with high BOO and no DU showed lower risk (OR, 0.321; P = 0.003). Notably, even among patients with high preoperative postvoid residual volume (PVR ≥ 300 mL), those with high BOO and preserved detrusor contractility still demonstrated lower TWOC failure risk (OR, 0.154; P = 0.018). Conclusions: Preoperative multichannel urodynamics enhance initial TWOC risk stratification and support individualized postoperative catheter management. Patients with DU and low BOO may require prolonged catheterization. In contrast, early catheter removal appears feasible in patients with high BOO and preserved detrusor function, even when preoperative PVRis elevated.  \nKeywords: Urodynamics; Urinary catheterization; Prostatic hyperplasia; Urinary bladder, Underactive; Urinary bladder neck obstruction  \n• Grant/Fund Support: This study received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.  \n• Research Ethics: The study was approved by the Institutional Review Board of National Cheng Kung University Hospital (IRB number: B-ER- 113-234).  \n• Conflict of Interest: No potential conflict of interest relevant to this article was reported.  \nCorresponding author: Kuen-Jer Tsai  [https://orcid.org/0000-0002-2170-9735](https://orcid.org/0000-0002-2170-9735)[ ](https://orcid.org/0000-0002-2170-9735)Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan  \n[Email: kjtsai@mail.ncku.edu.tw](Email: kjtsai@mail.ncku.edu.tw)  \nCo-corresponding author: Yin-Chien Ou  [https://orcid","cbCaigMxg7gy66Tb","https://ap.wps.com/l/cbCaigMxg7gy66Tb","pdf",552883,12,"English","# Introduction\n# Methods\n# Results\n# Conclusions","[{\"question\":\"What outcome defines initial TWOC failure in this study?\",\"answer\":\"Initial TWOC failure was defined as requiring recatheterization within 1 week after catheter removal.\"},{\"question\":\"Which preoperative urodynamic factors predicted initial TWOC failure?\",\"answer\":\"The study found detrusor underactivity and low bladder outlet obstruction as independent predictors of initial TWOC failure.\"},{\"question\":\"Can TWOC be attempted early for patients with high BOO and preserved detrusor function?\",\"answer\":\"Yes. Patients with high BOO and preserved detrusor contractility demonstrated lower TWOC failure risk even when preoperative postvoid residual volume was elevated (PVR ≥ 300 mL).\"},{\"question\":\"How should postoperative catheter management be individualized based on the findings?\",\"answer\":\"Preoperative multichannel urodynamics enable risk stratification. Patients with detrusor underactivity and low BOO may benefit from prolonged catheterization, whereas selected patients with high BOO and preserved detrusor function may be suitable for earlier catheter removal.\"}]","Predicting Initial Trial Without Catheter Failure After Prostate Deobstruction Surgery Using Preoperative Urodynamics | PDF",1790757250]