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    Korean J Urol. 2006 Jan;47(1):20-25. Korean.
    Published online Jan 31, 2006.
    https://doi.org/10.4111/kju.2006.47.1.20
    Copyright © 2006 The Korean Urological Association
    Original Article

    Follow-up Treatment of Benign Prostatic Hyperplasia with Acute Urinary Retention

    Jung-Hyun Shim, Inho Sohng, Keum-Nahn Jee,1 and Hyung-Jee Kim
      • Department of Urology, Dankook University College of Medicine, Cheonan, Korea.
      • 1Department of Radiology, Dankook University College of Medicine, Cheonan, Korea.
    • Corresponding author (Email: killtumor@yahoo.co.kr )
    Received May 18, 2005; Accepted September 14, 2005.

    Abstract

    Purpose

    One of the most serious complications of benign prostatic hyperplasia (BPH) is acute urinary retention (AUR). Up to now, many papers have evaluated the short term treatment of patients with AUR that is due to BPH. Therefore, we evaluated the long term follow-up of BPH patients with AUR.

    Materials and Methods

    154 BPH patients with AUR were divided into two groups. One group was considered to be the failure cases of urethral catheter removal, and this group (55 patients) had undergone immediately transurethral resection of prostate (TURP). The other group was considered to be the successful cases of urethral catheter removal. The latter group was divided into 3 groups: the α-blocker group, the α-blocker with 5 α-reductase inhibitor group and the suprapubic cystostomy with medical treatment group. We evaluated the long term follow-up of these groups and the changes of treatment for 1 month, 3 months, 6 months and 12 months.

    Results

    The mean volume of the prostate was 54.2ml. When the patients were admitted to the hospital due to AUR, 53% of the patients had previously experienced AUR, and the mean number of previous AUR episodes were 1.4 times. The initial management of AUR due to BPH was urethral catheter indwelling with medical treatment. If the catheter removal failed, TURP was perfomed (35%) and when successful, medical treatment was then done.

    Conclusions

    The primary management of AUR due to BPH is urethral catheter indwelling with medical treatment (α-blocker). However, if the patients have a large size prostate, we should first consider hormone treatment (5 α-reductase inhibitor) rather than surgical treatment. The management methods of some patients were changed during the follow-up. Therefore, when following up these cases, we should be careful to prevent the recurrence of AUR and to allow self-voiding.

    Keywords
    Acute disease; Urinary retention; Benign prostatic hyperplasia

    Figures

    Fig. 1
    The change of the IPSS for the medical treatment patients. IPSS: International Prostate Symptom Score.

    Tables

    Table 1
    The management and follow-up of AUR secondary to BPH

    Table 2
    Profiles of the medical treatment group

    Table 3
    Comparison of the previous AUR history group and the previous non-AUR history group

    Table 4
    Comparison of the operative group and the medication group

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    MeSH Terms
    Acute Disease
    Catheters
    Cystostomy
    Follow-Up Studies*
    Humans
    Oxidoreductases
    Prostate
    Prostatic Hyperplasia*
    Recurrence
    Transurethral Resection of Prostate
    Urinary Catheters
    Urinary Retention*
    Metrics
    Share
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