Higher mortality and morbidity rates in men presenting with AUR have been reported in previous studies.
This study has comprehensive comparisons of post-TURP complications between patients with and without AUR. Furthermore, it shows that AUR is associated with increased risk of complications after TURP.
OBJECTIVE: To assess the association between a history of acute urinary retention (AUR) and complications after transurethral resection of prostate (TURP).
PATIENTS AND METHODS: We conducted a retrospective, national, population-based study using Taiwan's National Health Insurance Research Database. We included men > 50 years old, diagnosed with benign prostatic hyperplasia (BPH) and divided these into two groups: an AUR+ group - those with AUR who underwent TURP between 2002 and 2004; and an AUR- group - those without AUR who underwent TURP between those dates. Prostate cancer, Parkinsonism and multiple sclerosis were exclusion criteria. Postoperative complications, e.g. re-catheterization, haematuria or urinary tract infection (UTI), were compared using crude odds ratios (ORs), 95% confidence intervals (CIs), and Student's t-test. A chi-squared test was used for potential confounding factors: preoperative UTI and anticoagulant use. Univariate and multivariate analysis on medical expenses were conducted.
RESULTS: The AUR+ group contained 3305 men; the AUR- group contained 1062. Re-catheterization (13.8%), septicaemia (1.1%) and shock (0.3%) were found only in the AUR+ group. The AUR+ group had more UTIs (18.9% vs. 15.6%, OR: 1.26, 95% CI: 1.05-1.52), more lower urinary tract symptoms (22.8% vs. 16.9%, OR: 1.45, 95% CI: 1.21-1.73), fewer blood transfusions (3.2% vs. 1.5%, OR: 2.19, 95% CI: 1.29-3.72) and higher medical expenses. There were no significant differences in haematuria, lower urinary tract stricture, or re-surgical intervention of the prostate and second-line antibiotic use.
CONCLUSION: Patients in Taiwan with BPH with AUR who were treated by TURP were associated with a higher risk of complications, longer hospital stay and more comorbidities than those without AUR and a preoperative warning is warranted for these patients.
Written by:
Chen JS, Chang CH, Yang WH, Kao YH. Are you the author?
Department of Urology Institute of Clinical Pharmacy, Medical College and Hospital, National Cheng Kung University, Tainan, Taiwan.
Reference: BJU Int. 2012 Oct 4. Epub ahead of print.
doi: 10.1111/j.1464-410X.2012.11471.x
PubMed Abstract
PMID: 23035623
