目的:本研究的目的是分析良性前列腺增生(BPH)患者复发性急性尿潴留(AUR)的特点,利用基于人口的数据集。此外,我们试图报告AUR是如何治疗的,特别是关于导管插入的需要和长度以及用于缓解的程序类型。
方法:使用Optum的去识别的Clinformatics®DataMart数据库进行了一项回顾性观察性队列研究。我们比较了两组,2003年1月1日至2017年12月31日,患有AUR的BPH患者(n=180,737)和无AUR的BPH患者(n=1,139,760)。此外,我们通过年龄校正多变量分析分析了影响AUR多次发作的因素.
结果:与47.7%的患者有单一的AUR发作相反,33.5%的AUR患者随后出现3次或更多次保留发作。对于年龄匹配的患者,随着年龄的增长,其他保留事件的风险显着增加,高加索种族,糖尿病,神经状况,或低收入。总的来说,在研究期间,AUR患者的BPH手术率下降,最常见的手术是经尿道前列腺电切术.
结论:AUR多次发作的危险因素包括年龄(60岁及以上),高加索种族,收入较低的社会经济地位,糖尿病,和神经系统疾病。建议发生AUR反复发作的可能性高的患者在此类AUR发生之前接受先发制人的BPH药物治疗。此外,当AUR发生时,应考虑更迅速的手术治疗,而不是临时导管插入术.
The objective of this study is to analyze characteristics of recurrent acute urinary retention (AUR) in patients with benign prostatic hyperplasia (BPH), utilizing a population based data set. Also, we sought to report on how AUR was treated, specifically regarding the need and length of catheterization and types of procedures utilized for mitigation.
A retrospective observational cohort study was performed using Optum\'s deidentified Clinformatics® Data Mart Database. We compared two groups, BPH patients with AUR (n = 180,737) and BPH patients without AUR (n = 1,139,760) from January 1, 2003 to December 31, 2017. Also, we analyzed the factors affecting the development of multiple episodes of AUR through age-adjusted multivariate analysis.
In contrast to the 47.7% of patients who had a single AUR episode, 33.5% of AUR patients developed 3 or more subsequent episodes of retention. For age matched patients, the risks of additional episodes of retention increase significantly with older age, Caucasian race, diabetes, neurologic conditions, or low income. Overall, the rate of BPH surgery in AUR patients over the study period decreased and the most common procedure was transurethral resection of the prostate.
Risk factors for multiple episodes of AUR included age (60 and older), Caucasian race, lower income socioeconomic status, diabetes, and neurological disorders. Patients with a high probability of developing recurrent episodes of AUR are recommended to receive preemptive BPH medication before such AUR occurrences. Also, more expeditious surgical treatment should be considered rather than temporary catheterization when AUR occurs.