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

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 5αreductase 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 (5α-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. (Korean J Urol 2006;47: 20-25)