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Incidence rates and risk factors for acute urinary retention: the health professionals followup study.

Abstract

PURPOSE

We define incidence rates and risk factors for acute urinary retention.

MATERIALS AND METHODS

In 1992, 41,276 United States male health professionals 45 to 83 years old self-reported baseline health data and American Urological Association symptom index scores. In 1995 a subset reported the year of any episode of acute urinary retention requiring catheterization. Of 8,418 respondents 6,100 without a history of prostate cancer, prostatectomy or acute urinary retention before 1992 provided data. Incidence rates from 1992 to 1995 were calculated and risk factors were assessed using logistic regression.

RESULTS

During 15,851 person-years of followup 82 men reported an episode of acute urinary retention (sampling weighted incidence 4.5/1,000 person-years, 95% confidence intervals 3.1 to 6.2). Rates increased with age and baseline symptom severity. In men with symptom score 0 to 7 (none or mild lower urinary tract symptoms) the incidence of acute urinary retention increased from 0.4/1,000 person-years for those 45 to 49 years old to 7.9/1,000 person-years for those 70 to 83 years old. In men with symptom score 8 to 35 (moderate or severe lower urinary tract symptoms) rates increased from 3.3/1,000 person-years for those 45 to 49 years old to 11.3/1,000 person-years for those 70 to 83 years old. Men with a clinical diagnosis of benign prostatic hyperplasia and a symptom score 8 or greater had the highest rates (age adjusted incidence 13.7/1,000 person-years). All 7 lower urinary tract symptoms comprising the American Urological Association symptom index individually predicted acute urinary retention (age adjusted odds ratio 1.8 to 2.9 for symptoms occurring more than 25% of the time during the last month). The sensation of incomplete bladder emptying, having to void again after less than 2 hours and a weak urinary stream were the best independent symptom predictors. Use of medications with adrenergic or anticholinergic side effects also predicted acute urinary retention.

CONCLUSIONS

Acute urinary retention occurred relatively infrequently but older age, moderate or severe lower urinary tract symptoms, a diagnosis of benign prostatic hyperplasia and specific drug therapies significantly increased the risk of occurrence.

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  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Massachusetts General Hospital, Department of Medicine, Harvard Medical School, Boston 02114, USA.

    , , , ,

    Source

    The Journal of urology 162:2 1999 Aug pg 376-82

    MeSH

    Acute Disease
    Aged
    Aged, 80 and over
    Follow-Up Studies
    Humans
    Incidence
    Male
    Middle Aged
    Prostatic Hyperplasia
    Risk Factors
    Severity of Illness Index
    Urinary Retention

    Pub Type(s)

    Journal Article
    Research Support, U.S. Gov't, P.H.S.

    Language

    eng

    PubMed ID

    10411042

    Citation

    Meigs, J B., et al. "Incidence Rates and Risk Factors for Acute Urinary Retention: the Health Professionals Followup Study." The Journal of Urology, vol. 162, no. 2, 1999, pp. 376-82.
    Meigs JB, Barry MJ, Giovannucci E, et al. Incidence rates and risk factors for acute urinary retention: the health professionals followup study. J Urol. 1999;162(2):376-82.
    Meigs, J. B., Barry, M. J., Giovannucci, E., Rimm, E. B., Stampfer, M. J., & Kawachi, I. (1999). Incidence rates and risk factors for acute urinary retention: the health professionals followup study. The Journal of Urology, 162(2), pp. 376-82.
    Meigs JB, et al. Incidence Rates and Risk Factors for Acute Urinary Retention: the Health Professionals Followup Study. J Urol. 1999;162(2):376-82. PubMed PMID: 10411042.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Incidence rates and risk factors for acute urinary retention: the health professionals followup study. AU - Meigs,J B, AU - Barry,M J, AU - Giovannucci,E, AU - Rimm,E B, AU - Stampfer,M J, AU - Kawachi,I, PY - 1999/7/20/pubmed PY - 1999/7/20/medline PY - 1999/7/20/entrez SP - 376 EP - 82 JF - The Journal of urology JO - J. Urol. VL - 162 IS - 2 N2 - PURPOSE: We define incidence rates and risk factors for acute urinary retention. MATERIALS AND METHODS: In 1992, 41,276 United States male health professionals 45 to 83 years old self-reported baseline health data and American Urological Association symptom index scores. In 1995 a subset reported the year of any episode of acute urinary retention requiring catheterization. Of 8,418 respondents 6,100 without a history of prostate cancer, prostatectomy or acute urinary retention before 1992 provided data. Incidence rates from 1992 to 1995 were calculated and risk factors were assessed using logistic regression. RESULTS: During 15,851 person-years of followup 82 men reported an episode of acute urinary retention (sampling weighted incidence 4.5/1,000 person-years, 95% confidence intervals 3.1 to 6.2). Rates increased with age and baseline symptom severity. In men with symptom score 0 to 7 (none or mild lower urinary tract symptoms) the incidence of acute urinary retention increased from 0.4/1,000 person-years for those 45 to 49 years old to 7.9/1,000 person-years for those 70 to 83 years old. In men with symptom score 8 to 35 (moderate or severe lower urinary tract symptoms) rates increased from 3.3/1,000 person-years for those 45 to 49 years old to 11.3/1,000 person-years for those 70 to 83 years old. Men with a clinical diagnosis of benign prostatic hyperplasia and a symptom score 8 or greater had the highest rates (age adjusted incidence 13.7/1,000 person-years). All 7 lower urinary tract symptoms comprising the American Urological Association symptom index individually predicted acute urinary retention (age adjusted odds ratio 1.8 to 2.9 for symptoms occurring more than 25% of the time during the last month). The sensation of incomplete bladder emptying, having to void again after less than 2 hours and a weak urinary stream were the best independent symptom predictors. Use of medications with adrenergic or anticholinergic side effects also predicted acute urinary retention. CONCLUSIONS: Acute urinary retention occurred relatively infrequently but older age, moderate or severe lower urinary tract symptoms, a diagnosis of benign prostatic hyperplasia and specific drug therapies significantly increased the risk of occurrence. SN - 0022-5347 UR - https://www.unboundmedicine.com/medline/citation/10411042/Incidence_rates_and_risk_factors_for_acute_urinary_retention:_the_health_professionals_followup_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022-5347(05)68563-1 DB - PRIME DP - Unbound Medicine ER -