Predictors of Acute Urinary Retention in Benign Prostatic Hyperplasia - A Comparative Study in Patients with Acute Urinary Retention and Without Retention

Abstract

Aim of the Study: To accurately determine factors that predict acute urinary retention in patients with benign prostatic hyperplasia (BPH) by comparing patients presenting with acute urinary retention (AUR) to patients without urinary retention. Study Design: Prospective observational analytical study. Materials and Methods: All men presenting with lower urinary tract symptoms (LUTS), with and without urinary retention, clinically and radiologically diagnosed to have BPH were compared. 63 patients were enrolled in the study. Among them, 32 patients presented with AUR and 31 patients presented with LUTS only. International prostate symptom scoring (IPSS) grading, digital rectal examination (DRE) and abdominal ultrasonogram (USG) were used to assess symptoms, clinical prostate enlargement and prostate size respectively. Parameters Compared: Age , comorbid illnesses, previous history of urinary retention, presence of urinary tract infection, IPSS symptom severity and grading , prostate size grading as per digital rectal examination , size of prostate and intravesical protrusion of prostate (IPP) grading as per ultrasound study ,thickness of bladder wall(BWT)by ultrasound, and serum prostatic specific antigen (PSA) level. Statistical Analysis: Statistical package for social sciences, version 12.0.2 (SPSS, Inc. Chicago, USA) was used for statistical analysis. The mean, standard deviation, minimal, maximal values were calculated and the baseline parameters values in both groups were analyzed using student unpaired t test. All discrete variables were analyzed by Chi Square test. All data were analyzed using SPSS computer program and p <0.05 was considered statically significant. Conclusion: Symptom severity, previous AUR episodes, high serum PSA levels, increased size of prostate ,increased bladder wall thickness, increased intravesical prostatic projection length are accurate predictors of acute urinary retention in patients with benign prostatic hyperplasia. Those patients who are at risk can be offered earlier treatment options, could be either medical or surgical intervention to prevent AUR.