Postoperative Hematuria Is the Key to Achieving No Indwelling Urethral Catheter Immediately After Prostatic Urethral Lift: A Japanese Single-Center Prospective Study.

The postoperative urethral catheter-free has been possible immediately after prostatic urethral lift (PUL) for benign prostatic hyperplasia; however, there are no specific criteria for urethral catheter-free status. This study evaluated the efficacy of the criteria for urethral catheter-free status after PUL. We evaluated the criteria for urethral catheter-free status after PUL on hematuria grade and prospectively reviewed the results. The grade of hematuria was assessed on a scale of five levels. This study was classified as Group A-postoperative urethral catheter-free when hematuria Grade 3 or lower at the end of PUL; and Group B-postoperative urethral catheter insertion when hematuria Grade 4 or higher. A total of 45 patients were included in the study. The median age was 81, and the prostate volume was 34 mL. There were 36 patients (80%) in Group A and 9 (20%) in Group B. In Group A, 26 patients (72%) achieved postoperative catheter-free immediately after PUL, and in the other 10 patients, the urethral catheter was inserted due to transient urinary retention. In Group B, 7 patients (78%) achieved postoperative urethral catheter-free 1 day after PUL. There was no significant difference in postoperative voiding status between the two groups. We evaluated the utility and safety of a protocol using postoperative hematuria grade as a decision-making tool for early urethral catheter removal following PUL. This hematuria-grade-based catheter removal protocol after PUL was generally feasible and safe.