INTRODUCTION: Acute urinary retention (AUR) is a serious complication in patients with benign prostatic hyperplasia (BPH). Some risk factors for AUR are known. However, it is important to study patients in different geographic locations because of cultural, dietary, medical, and lifestyle differences. The purpose of the present retrospective investigation was to compare patients with BPH and without AUR to patients with BPH and AUR from the Islamic Republic of Iran on a variety of possible risk factors.
METHODS: We reviewed files of 430 adult patients with BPH who were admitted for surgery from 2003 through 2008. The examined variables were: patient age, PSA, prostate volume, previous history of AUR, anesthesia, smoking, alcohol consumption, opium addiction, diabetes mellitus, hypertension, cardiovascular disease, and other comorbid diseases. There were 270 patients (66.2%) without a history of AUR and 138 patients (33.8%) with a history of AUR. Data for the 2 patient groups were compiled and compared using chi-square, Mann-Whitney, or Fisher exact tests. Logistic regression was calculated for the variables that resulted in significant group differences.
RESULTS: Mean (SD) patient age was 68 (9) years and 72 (9) years for patients without and with AUR, respectively (P < .003). Patients with AUR had a significantly larger mean prostate volume of 62.8 (23) mL, compared with 48 (21) mL for patients without AUR (P < .0001). Significantly more patients without AUR had low PSA levels (P < .001). However, the largest number of patients in both groups had a PSA over 4 ng/mL (44.8% of patients without AUR; 57.2% of patients with AUR). There was no significant group difference in the number of patients consuming alcohol or the number with opium addiction, hypertension, cardiovascular disease, or other underlying diseases (P > .05). Significantly more patients without AUR had diabetes mellitus (P < .001). Significantly more patients with AUR were smokers (P < .001).
CONCLUSIONS: Patient age, high prostate volume, high serum PSA, and smoking were the main risk factors for AUR. These outcomes were consistent with previous research with patients from other geographic locations.
Siavash Falahatkar, Ali Hamidi Madani, Ahmad Enshaei, Ehsan Kazemnejad, Seyedeh Samaneh Ahmadi, Keivan Gholamjani Moghaddam, Aliakbar Allahkhah
Urology Research Center, Guilan University of Medical Science, Razi Hospital, Rasht, Islamic Republic of Iran
Submitted September 16, 2010 - Accepted for Publication October 29, 2010
KEYWORDS: Acute urinary retention; Benign prostatic hyperplasia; Prostate-specific antigen; Prostate volume; Risk factor.
CORRESPONDENCE: Ali Hamidi Madani MD, Assistant Professor of Urology, Urology Research Center, Guilan University of Medical Science, Razi Hospital, Sardar Jangal Street, Rasht, 41448, I.R.Iran (
CITATION: UroToday Int J. 2010 Dec;3(6). doi:10.3834/uij.1944-5784.2010.12.15
ABBREVIATIONS AND ACRONYMS: AUR, acute urinary retention; BPH, benign prostatic hyperplasia; DM, diabetes mellitus; LUTS, lower urinary tract symptoms; MTOPS, medical therapy of prostatic symptoms; QoL, quality of life; PSA, prostate-specific antigen; TURP, transurethral resection of the prostate; TWOC, trial without catheter.