Abstract
ABSTRACTIntroduction:The urinary bladder diverticula (BD) secondary to benign prostatic hyperplasia (BPH) is a complication that can lead to urinary stasis, stone, urinary tract infection (UTI) and tumors. It's role in acute urinary retention (AUR) is not totally understood.Objectives:To determine the effect of BD size on AUR rates in patients with BPH candidates to surgery.Subjects and Methods:We performed a retrospective cohort study of 47 patients with BPH and BD who underwent BPH surgery associated to complete bladder diverticulectomy from 2006 to 2016. We analyzed risk factors for AUR in patients with BD using univariate, multivariate and correlation analysis.Results:There was a difference in the size of the diverticula, with 6.8 cm vs. 4.5 cm among patients with and without AUR respectively (p=0.005). The ROC curve showed a correlation between the size of BD and the risk of AUR. The value of 5.15 cm presented a sensitivity of 73% and a specificity of 72%. The area under the curve was 0.75 (p=0.01). Comparing groups with BD >5.0 cm vs. ≤5.0 cm, the AUR incidence was 74% and 27.8% respectively with an OR of 2.65 (1.20-5.85) (p=0.005). In the multivariate analysis, only the size of the diverticula reached statistical significance (p=0.012).Conclusions:The diameter of BD is an independent risk factor for AUR in patients with BPH and BD who are candidates to surgery. A diameter greater than 5.15 cm increases the risk of AUR.
Highlights
The urinary bladder diverticula (BD) secondary to benign prostatic hyperplasia (BPH) is a complication that can lead to urinary stasis, stone, urinary tract infection (UTI) and tumors
There was a difference in size of the diverticula, with 6.8 cm (±2.5) vs. 4.5 cm (±2.0) (p=0.005) in patients with and without acute urinary retention (AUR), respectively
The Proscar Long-Term Efficacy and Safety Study (PLESS) control arm showed that 7% of the patients with BPH followed for four years had AUR [7]
Summary
The urinary bladder diverticula (BD) secondary to benign prostatic hyperplasia (BPH) is a complication that can lead to urinary stasis, stone, urinary tract infection (UTI) and tumors. Conclusions: The diameter of BD is an independent risk factor for AUR in patients with BPH and BD who are candidates to surgery. The bladder diverticula (BD) secondary to benign prostatic hyperplasia (BPH) is more common in elderly men with an incidence range from 1 to 8% [1]. The widespread use of medical treatment for BPH in the last 20 years may have caused an ibju | Size of BD is a risk factor for AUR elevated incidence of BD due to an increase of bladder damage secondary to longer periods of obstruction
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