Acute urinary retention increases the risk of complications after transurethral resection of the prostate: a population-based study

作者：Chen Jeng Sheng; Chang Chia Hsien; Yang Wen Horng^*; Kao Yea Huei

来源：BJU International, 2012, 110(11C): E896-E901.

DOI：10.1111/j.1464-410X.2012.11471.x

• acute urinary retention
• benign prostate hyperplasia
• transurethral resection of prostate
• postoperative complication

OBJECTIVE %26lt;br%26gt;To assess the association between a history of acute urinary retention (AUR) and complications after transurethral resection of prostate (TURP). %26lt;br%26gt;PATIENTS AND METHODS %26lt;br%26gt;We conducted a retrospective, national, population-based study using Taiwan%26apos;s National Health Insurance Research Database. %26lt;br%26gt;We included men %26gt; 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. %26lt;br%26gt;Prostate cancer, Parkinsonism and multiple sclerosis were exclusion criteria. %26lt;br%26gt;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%26apos;s t-test. %26lt;br%26gt;A chi-squared test was used for potential confounding factors: preoperative UTI and anticoagulant use. %26lt;br%26gt;Univariate and multivariate analysis on medical expenses were conducted. %26lt;br%26gt;RESULTS %26lt;br%26gt;The AUR(+) group contained 3305 men; the AUR -group contained 1062. %26lt;br%26gt;Re-catheterization (13.8%), septicaemia (1.1%) and shock (0.3%) were found only in the AUR(+) group. %26lt;br%26gt;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. %26lt;br%26gt;There were no significant differences in haematuria, lower urinary tract stricture, or re-surgical intervention of the prostate and second-line antibiotic use. %26lt;br%26gt;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.

• 出版日期2012-12