ORIGINAL ARTICLE
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Transurethral resection of prostate for acute urinary retention is linked to shorter survival in younger men


1 S. H. Ho Urology Centre, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
2 Division of Biostatistics, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
3 Division of Urology, Department of Surgery, North District Hospital, Hong Kong, China
4 Division of Urology, Department of Surgery, Alice Ho Miu Ling Nethersole Hospital, Hong Kong, China

Correspondence Address:
Chi-Kwok Chan,
S. H. Ho Urology Centre, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China

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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/aja.aja_101_18

PMID: 30648670

It is largely unknown whether lower urinary tract symptoms (LUTS) or acute retention of urine (AROU) is linked to shorter life expectancy in men. We conducted a multicenter, retrospective database analysis of patients undergoing transurethral resection of prostate (TURP) to study their relationships. Multivariate Cox regression analysis and Kaplan–Meier analysis with stratification to age and indication of TURP were performed. We further performed an age- and sex-matched survival analysis with the general population using data from the Census and Statistics Department of the Hong Kong Special Administrative Region (Hong Kong, China). From January 2002 to December 2012, 3496 patients undergoing TURP were included in our study, with 1764 patients in the LUTS group and 1732 patients in the AROU group. Old age, ischemic heart disease, cerebrovascular accident, and AROU were risk factors of mortality. Patients aged <70 years (adjusted hazard ratio [HR]: 1.52, 95% confidence interval [CI]: 1.11–2.09, P = 0.010) and 70–80 years (adjusted HR: 1.39, 95% CI: 1.15–1.70, P = 0.001) in the AROU group had worse survival than those in the LUTS group, but such difference was not demonstrated in patients aged >80 years. Compared to the general population, younger patients in the LUTS group appeared to have better survival (<70 years, P = 0.091; 70–80 years, P = 0.011), but younger patients in the AROU group had worse survival (<70 years, P = 0.021; 70–80 years, P = 0.003). For patients aged >80 years, survival was similar with the general population in both the LUTS and AROU groups. In conclusion, AROU at young age was associated with mortality, while early detection and management of LUTS may improve survival.


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