Predictors of urinary retention in benign prostate hyperplasia
DOI:
https://doi.org/10.18203/2320-6012.ijrms20160301Keywords:
BPH, Predictors, PVR, PSA, Acute urinary retentionAbstract
Background: Acute urinary retention (AUR) is one of the most significant complications or long-term outcomes of benign prostatic hyperplasia (BPH). Because of the high prevalence of BPH and its effect on the patient's quality of life, additional research is needed to better predict the risk factors of AUR. The study was aimed to find out the incidence and factors responsible for retention of urine in BPH.
Methods: It was a prospective study, conducted at a medical college after the approval from IEC. The study included the patients admitted to the surgical wards admitted with the symptoms of lower urinary tract symptom and presented with acute urinary retention. Duration of the study was 2 months. A total 40 patients were studied over this duration. The outcome of the study was analyzed by these factors: Age in years, Symptom severity, Prostate Volume on DRE and USG Grade.
Results: The mean age of presentation was 64.87±7.85 with median age of 65 years (range 45-82 years) with mean IPSS score of 17.45and the mean PVR was 110.80 ± 85.52 with median 110 (range 0-500). Maximum number of patients having Grade 3 and 4 enlargements had PSA level 9-12 ng/ml. The PSA levels and the grade of enlargement on USG were statistically significant (p-0.004).
Conclusions: Out of the four factors considered to be the independent risk factors, all of them have positive correlation with the symptom of acute urinary retention. None of these four factors i.e. age in years, symptom severity, prostate Volume on DRE and USG grade could establish significant correlation.
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References
Holtgrewe HL, Mebust WK, Dowd JB. Transurethral prostatectomies: practical aspects of the dominant operation in American urology. J Urol. 1989;141:248-53.
Breum L, Klarskov P, Munck LK. Significance of acute urinary retention due to infravesical obstruction. Scand J UrolNephrol. 1982;16:21-4.
Tuncel A, Uzun B, Eruyar T, Karabulut E, Seckin S, Atan A. Do prostatic infarction, prostatic inflammation and prostate morphology play a role in acute urinary retention? Eur Urol. 2005;48:277-84.
Gratzke C, Reich O, Staehler M, Seitz M, Schlenker B, Stief CG. Risk Assessment and Medical Management of Acute Urinary Retention in Patients with Benign Prostatic Hyperplasia. EAU-EBU Update Series. 2006;4(3):109-16.
Kaplan SA, Wein AJ, Staskin DR, Roehrborn CG, Steers WD. Urinary retention and post-void 2006; 4(3):10residual urine in men: separating truth from tradition. J Urol. 2008;180(1):47-54.
Kirby RS. The natural history of benign prostatic hyperplasia: what have we learned in the last decade? Urology. 2000;56(1):3-6.
Meigs JB, Barry MJ, Giovannucci E, Rimm EB, Stampfer MJ, Kawachi I. Incidence rates and risk factors for acute urinary retention: the health professionalsfollowup study. J Urol. 1999;162(2):376-82.
Fitzpatrick JM. The natural history of benign prostatic hyperplasia. BJU Int. 2006;97(2):3-6;21-22.
Fitzpatrick JM, Artibani W. Therapeutic strategies for managing BPH progression. EurUrol Suppl. 2006;5(20):997-1003.
Hargreaves TB, McNeill AS. Acute urinary retention in men: the risks and outcomes with medical therapy. Curr Urol Rep. 2005;6(4):263-70.
Emberton M. Definition of at-risk patients: dynamic variables. BJU Int. 2006;97(2):12-5;21-2.
Verhamme KM, Die leman JP, van Wink MA, Bosch JL, Stricker BH, Sturkenboom MC. Low incidence of acute urinary retention in the general male population: the triumph project. Eur Urol. 2005;47(4):494-8.
Marks LS, Roehrborn CG, Andriole GL. Prevention of benign prostatic hyperplasia disease. J Urol. 2006;176:1299-306.
Jacobsen SJ, Jacobson DJ, Girman CJ. Natural history of prostatism: risk factors for acute urinary retention. J Urol. 1997;158(2):481-7.
Emberton M, Anson K. Acute urinary retention in men: an age old problem. BMJ. 1999;318(7188):921-5.
Thomas K, Chow K, Kirby RS. Acute urinary retention: a review of the etiology and management. Prostate Cancer Prostatic Dis. 2004;7(1):32-7.
Marberger MJ, Andersen JT, Nickel JC. Prostate volume and serum prostate-specific antigen as predictors of acute urinary retention. Combined experience from three large multinational placebo-controlled trials. Eur Urol. 2000;38(5):563-8.
Crawford ED, Wilson SS, McConnell JD. MTOPS Research Group. Baseline factors as predictors of clinical progression of benign prostatic hyperplasia in men treated with placebo. J Urol. 2006;175(4):1422-6.
Murray K, Massey A, Feneley RC. Acute urinary retention - an urodynamic assessment. Br J Urol. 1984; 56:468-73.
Muruganandham K, Dubey D, Kapoor R. Acute urinary retention in benign prostatic hyperplasia: Risk factors and current management Indian J Urol. 2007;23(4):347-53.
Cathcart P, van der Meulen J, Armitage J, Emberton M. Incidence of primary and recurrent acute urinary retention between 1998 and 2003 in England. J Urol. 2006;176:200-4.
Kefi A, Koseoglu H, Celebi I, Yorukoglu K, Esen A Relation between acute urinary retention, chronic prostatic inflammation and accompanying elevated prostate-specific antigen. Scand J Urol Nephrol. 2006;460(2):155.
Roehrborn CG, Acute Urinary Retention: Risks and Management Rev Urol. 2005;7(4):31-41.
Lepor H, Managing and Preventing Acute Urinary Retention Rev Urol. 2005;7(8):26-33.
Tuncel A, Uzun B, Eruyar T, Karabulut E, Seckin S, Atan A. Do prostatic infarction, prostatic inflammation and prostate morphology play a role in acute urinary retention? Eur Urol. 2005;48(2):277-83.
Aliasgari M, Soleimani M, Moghaddam HSM. The effect of acute urinary retention on serum prostate-specific antigen level. Urol J. 2005;2(2):89-92.
Nan Ke Xue Z. The effect of acute urinary retention on serum prostate specific antigen concentration. 2002;8(2):134-5.
Sagnier PP, McFarlane G, Teillac P, Botto H, Richard F, Boyle P. Impact of symptoms of prostatism on level of bother and quality of life of men in the French community. J Urol. 1995;15:669-73.
Berges RR, Pientka L. Management of the BPH syndrome in Germany: who is treated and how? Eur Urol. 1999;36(3):21-7.
Roehrborn CG, McConnell JD, Bonilla J, Rosenblatt S, Hudson PR, Malek GH. Serum prostate specific antigen is a strong predictor of future prostate growth in men with benign prostatic hyperplasia. J Urol. 2000;163:13-20.
Rhodes T, Girman CJ, Jacobsen SJ, Robrts RO, Lieber MM. Serum PSA levels predict acute urinary retention in 40–79 year old community men in Olmsted County (abstract). J Urol. 1999;161:288.
McConnell JD, Bruskewitz R, Walsh P. The effect of finasteride on the risk of acute urinary retention and the need for surgical treatment among men with benign prostatic hyperplasia. N Engl J Med. 1998;338:557-63.