Effects of forced diuresis achieved by oral hydration and oral diuretic administration on uroflowmetric parameters and clinical waiting time of patients with lower urinary tract symptoms

Introduction: We studied the impact of diuresis forced by oral hydration or single-dose oral diuretic administration on uroflowmetric parameters and clinical waiting time of patients with lower urinary tract symptoms. Patients and Methods: A total of 58 patients with a mean age of 59 (range 41-77) years who presented with lower urinary tract symptoms were included in the study. The patients were grouped with respect to their International Prostate Symptom Scores as having mild, moderate, or severe symptoms. The prostatic volumes of the patients were calculated using transrectal ultrasound. Uroflowmetric measurements were performed on 3 consecutive days. On the 1st day, the test was performed without diuretic stimulation; on the 2nd day, oral hydration was applied, and on the 3rd day, the patients received 20 mg of furosemide orally. Voiding time, maximum flow rate, voided volume, and the time elapsed in minutes until voiding (waiting time) were recorded. Results: Diuretic stimulation did not significantly alter the uroflowmetric paramesters in each symptom group, but the waiting time was significantly reduced. Forced diuresis caused acute urinary retention in 5 of 20 (25%) severely symptomatic patients. Conclusions: Forced diuresis with oral hydration or oral administration of diuretics improves patient comfort and test applicability by shortening clinical waiting time and reducing the number of attempts to reach the sufficient urine volume for reliable measurements and can be applied safely for mild and moderately symptomatic patients. On the other hand, the risk of 25% of acute urinary retentions should be reconsidered, and the decision about diuretic stimuli should be made carefully by the clinician in severely symptomatic patients. Copyright (C) 2003 S. Karger AG, Basel.