The Risk Factors for Increased Post-Voiding Residual Urine Volume after Long-Term Anticholinergic Therapy in Patients with Benign Prostatic Hyperplasia and Overactive Bladder

Abstract

Purpose: Adding anticholinergics to the treatment regimen of benign prostatic hyperplasia (BPH) patients with overactive bladder (OAB) elicits concern about deterioration of obstructive symptoms and the possibility of urine retention. We evaluated the risk factors increasing post-voiding residual (PVR) volume with long-term anticholinergics therapy of over 1 year in patients with BPH and OAB. Materials and Methods: We selected patients with BPH and OAB from 2005 to 2007 who were more than 40 years old, were treated with αblockers, had an International Prostate Symptom Score (IPSS) of 8 or more, and had an IPSS urgency score of 2 or more for OAB. The 98 patients selected were evaluated by age, diabetes mellitus, central nervous system (CNS) disease above the brain stem, prostate volume, uroflowmetry, PVR volume, prostate-specific antigen (PSA) level, and IPSS retrospectively. We evaluated risk factors for increasing PVR volume over 50 ml and 100 ml after treatment and analyzed the risk factors both univariately and multivariately. Results: Age, diabetes mellitus, CNS disease, PSA level, prostate volume, initial PVR volume, peak urine flow rate (≤15 ml/s), use of anticholinergics, and no use of 5-α-reductase inhibitor, which were regarded as risk factors for increasing PVR volume, were analyzed for their relation with PVR volume over 50 ml and 100 ml, respectively. Age, initial PVR volume, CNS disease, and use of anticholinergics were significantly associated with an increased PVR volume over 100 ml in the univariate analysis. In multivariate analysis, age, initial PVR volume, CNS disease, and use of anticholinergics remained significantly associated with an increased PVR volume over 100 ml. Conclusions: Age (≥65 years), initial PVR (≥50 ml), long-term therapy with anticholinergics of over 1 year, and CNS disease appear to be risk factors for increasing PVR volume over 100 ml in patients with BPH and OAB. (Korean J Urol 2009;50:982-988) 󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏