Correlation between intravesical prostatic protrusion and prostate volume in patients presenting with acute urinary retention - A descriptive study

Patients who failed a catheter-free trial after acute urinary retention and one week of full dose alpha-blocker and 5-alpha-reductase inhibitor were offered Diethylstilbestrol 1 mg plus Aspirin 100 mg over 4 weeks. Prostate volume, age, serum creatinine, and initial retention drained urine volume were recorded. After excluding cardiovascular morbidity (n=7), upper urinary tract dilation (n=3), compromised renal function (n=2), urinary tract infection (n=2), neurological diagnosis (n=2), or preferred immediate channel transurethral resection of prostate (n=5), 48 of 69 consecutive patients ≥70 years were included. Mean age was 76.6 years (70–84), mean prostate volume 90 cm3(42–128), and mean follow-up 204 days; 58% (28/48) were passing urine and 42% (20/48) were catheter dependent after 4 weeks Diethylstilbestrol trial. Mean age and drained urine volume of catheter dependent patients were 82.4 years and 850 mL compared with 74.6 years and 530 mL in catheter-free men, respectively. Age and drained urine volume were independent predictors of catheter-free trial (bothP<0.01). Seventy-five percent (6/8) of patients 80 years and older were catheter dependent. Transient nipple/breast tenderness and gynecomastia were the only adverse effects reported by 21% (10/48) and 4% (2/48), respectively. No patient presented severe complications.

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Monotherapy versus combination therapy in the treatment of benign prostatic hyperplasia: A single center study

Zanco Journal of Medical Sciences ◽

10.15218/zjms.2020.039 ◽

2020 ◽

Vol 24 (3) ◽

pp. 333-337

Author(s):

Wishyar Al-Bazzaz ◽

Omar Alkhayat ◽

Ali AlKhayat

Keyword(s):

Benign Prostatic Hyperplasia ◽

Combination Therapy ◽

Urinary Retention ◽

Prostate Specific Antigen ◽

Acute Urinary Retention ◽

Prostate Volume ◽

Combined Treatment ◽

Specific Antigen ◽

Prostatic Hyperplasia ◽

Once Daily

Background and objectives: Most benign prostatic hyperplasia patients do not present obvious indicators for surgical intervention, so most of these patients are treated initially with medical therapy. This study aimed to compare the incidence of acute urinary retention after treatment with monotherapy with the incidence after combination therapy and determine the need for surgery in both methods. Methods: This is a retrospective study of the medical records of 248 benign prostatic hyperplasia patients who had attended Rizgary Teaching Hospital from May 2012 to June 2017. These patients were divided into two groups of 138 and 110 patients who have been treated by 0.4 mg tamsulosin capsule once daily and 0.4 mg tamsulosin capsule plus 5mg finasteride tablet once daily, respectively. Benign prostatic hyperplasia outcomes (acute urinary retention, benign prostatic hyperplasia related surgery) were compared between these two groups according to prostate volume and serum prostate specific antigen. Results: The combined treatment had significantly reduced the incidence of acute urinary retention and benign prostatic hyperplasia related surgery than monotherapy (P = 0.006 and 0.044, respectively). Similarly, when prostate volume and prostate specific antigen were above the cutoff value, both acute urinary retention and benign prostatic hyperplasia related surgery were lower in the combination therapy group than the monotherapy group. Conclusion: Combined therapy (0.4 mg tamsulosin plus 5mg finasteride) was significantly superior to 0.4 mg tamsulosin alone in the reduction of the incidence of acute urinary retention and benign prostatic hyperplasia related surgery among benign prostatic hyperplasia patients. Keywords: Benign prostatic hyperplasia; Acute urinary retention; Benign prostatic hyperplasia related surgery; Prostate volume; Prostate specific antigen.

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Predictive Factors for Acute Urinary Retention After Transperineal Template-Guided Mapping Biopsy

The Korean Journal of Urological Oncology ◽

10.22465/kjuo.2021.19.3.148 ◽

2021 ◽

Vol 19 (3) ◽

pp. 148-154

Author(s):

Si Hyun Sung ◽

Chung Un Lee ◽

Jae Hoon Chung ◽

Wan Song ◽

Minyong Kang ◽

...

Keyword(s):

Logistic Regression ◽

Urinary Retention ◽

Predictive Factors ◽

Odds Ratio ◽

Multivariate Regression ◽

Acute Urinary Retention ◽

Prostate Volume ◽

Common Complication ◽

Multivariate Regression Model ◽

Mapping Biopsy

Purpose: We investigated the predictive factors for acute urinary retention (AUR) after transperineal template-guided mapping biopsy (TTMB).Materials and Methods: We retrospectively reviewed the records of 459 patients who had undergone TTMB between May 2017 and July 2020. Overall complications after TTMB were analyzed and categorized according to the Clavien-Dindo classification. Factors that were likely to affect AUR were analyzed using a logistic regression model.Results: Overall complications after TTMB were observed in 95 of the 459 patients (20.7%), of which AUR was the most commonly reported (17.4%, n=80), followed by hematuria (3.1%, n=14). Hematuria in one patient was categorized as Clavien-Dindo grade IIIa. All remaining complications were Clavien-Dindo grade I. In the multivariate regression model, age ≥65 (odds ratio, 2.44; 95% confidence interval [CI], 1.42–4.17; p=0.001), prostate volume ≥30 mL (odds ratio, 3.72; 95% CI, 1.19–11.62; p<0.02), and number of biopsy cores ≥30 (odds ratio, 2.89; 95% CI, 1.29–6.43; p=0.01) were identified as the predictors for AUR after TTMB.Conclusions: AUR is the most common complication after TTMB. Age ≥65 years, prostate volume ≥30 mL, and number of biopsy cores ≥30 were significant predictors of AUR following TTMB.

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A clinico pathological study and management of benign enlargement of prostate

International Surgery Journal ◽

10.18203/2349-2902.isj20180992 ◽

2018 ◽

Vol 5 (4) ◽

pp. 1275 ◽

Cited By ~ 1

Author(s):

Ashish Mor ◽

Surender Mohan Sharma ◽

Sujoy Mukherjee ◽

Rishi Jindal

Keyword(s):

Urinary Retention ◽

Acute Urinary Retention ◽

Prostate Volume ◽

Stone Formation ◽

Prostate Gland ◽

Digital Rectal Examination ◽

Pathological Study ◽

Significant Relation ◽

Residual Urine ◽

Severe Group

Background: Benign prostatic hyperplasia (BPH) is the non-malignant enlargement of the prostate gland. Prolonged obstructions may eventually lead to acute urinary retention, recurrent urinary tract infection, hematuria, bladder calculi, and renal insufficiency.Methods: Hundred cases of benign enlargement of prostate were studied from November 2015 to 2016. Patients diagnosed as benign enlargement of prostate by clinical digital rectal examination, investigation like USG were included in this study. Patients with urinary retention due to strictures and urolithiasis, carcinoma were excluded.Results: Mean age of presentation was 64.4, and 34% were found to be in severe group of IPSS grading. There was a significant co-relation between the PVRU and prostate volume. There were 16% cases of acute urinary retention, 2% cases presented with bladder stones. Benign enlargement of prostate, IPSS score, Post voidal residual urine has a weak correlation with the increasing age as observed.Conclusions: Benign enlargement of prostate is a disease of elderly with peak incidence in the 5th and 6th decade of life, BPH has co-relation with inguinal hernia, AUR which is 16%. There was no correlation between the age of the patient and the severity of symptoms with respect to IPSS score. There was no correlation between the age of the patient and the severity of symptoms with respect to IPSS score. In present study there was a statistically significant relation were found between prostate volume and post voidal residual urine. Large amount of residual urine is the indication for surgery because it predisposes to infections and stone formation.

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