The risk factors for acute urinary tract retention (PPT)-2.pptx

8/10/2019 The risk factors for acute urinary tract retention (PPT)-2.pptx

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The risk factors for acute urinary tract

retention in patients with benign

prostate hyperplasia

Hseyin Cihan Demirel, Cevdet Serkan Gkkay1, Cneyt zden, Binhan KaanAkta, Sleyman Bulut, Ali Memi, etin Volkan ztekin.

Turkish Journal of Urology 2012; 38(2): 65-69 doi:10.5152/tud.2012.016

Anggi Miranda Tanjung03010031Devina Pangastuti - 03010079


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Abstract

Objective:

BPH most common cause of obstructive acute urinary retention

Acute urinary retention prostate inflammation

(AUR) in BPH age

weight of resected prostate tissue (Rt)

total prostate specific antigen level (tPSA)

Materials & methods:

JanuaryDecember 2008

226 BPH patients who underwent transurethral resection of prostate (TURP)

AUR (+) (n=89) and AUR (-) (n=137)


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Age, weight of resected prostatic tissue (Rt), total prostate specific antigen (tPSA)

levels and the presence of inflammation in the prostate.

P values 25 g resected prostate tissue independent risk factors for AUR

prostatic inflammation


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Abstract

Conclusion:

Age > 70 years

> 25 g resected prostate tissue independent risk factors for AUR

prostatic inflammation


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Introduction

Acute urinary retention (AUR): painful urologic condition

requiring rapid bladder decompression.

suprapubic pain and an inability to urinate

The most common cause of obstructive AUR is benign

prostatic hyperplasia (BPH)

The risk of AUR increases with age (10-30% with every 5-

year age increase).


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Materials and methods

JanuaryDecember 2012

226 patients

Inclusion: transurethral resection of prostate (TURP)

AUR

lower urinary tract symptoms (LUTS)

Exclusion: history of lower urinary tract surgery

prostate cancer

neurological disease

previous urethral catheterization due to any etiology

urinary tract infection


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AUR (+) group: 89 patients (39.38%)

AUR (-) group: 137 patients (60.62%)

Detailed medical history:

IPSS (International prostate symptom score)

Total PSA

Digital rectal examination (DRE)

Transrectal ultrasound (TRUS)

Uroflowmetry


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Resection: TURP technique with a 26-F continuous irrigation

resectoscope and monopolar energy

Weigh: high-sensitivity electronic scale

Data analysis:

The Statistical Package for Social Sciences (SPSS) version 13.0.

Pearsons,chi-squared test and the Mann-Whitney U test

p values 0.05 were considered significant.


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Results


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Results


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Results


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Results


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Discussion

AURdecrease thepatientsquality of life

Many etiologic factors have been identified BPH is thought to be

the most prevalent, but the exact causative mechanism remains under

debate

Present study confirmed the relationshop between age and the

development of AUR


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Discussion

Roehrborn et al: Large prostatic volume and high PSA level were

found to be the strongest predictors of the occurrence of AUR

Kefi et al: No difference between the patients with and without AUR

with respect to prostatic volume and the weight of resected prostatic

tissue

Tuncel et al and Atan et al: Serum tPSA level was an important risk

factor in AUR etiology

Our findings were opposite to theirs


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Discussion

Van Vuuren et al: The risk of developing AUR was twice as likely in

BPH patients as in prostate cancer patients if prostatitis was present

concomitantly

Asgari et al: Presence of prostatitis was a risk factors for AUR

There are several studies in the literature that speculate on the

relationship between inflammatory prostatitis and serum tPSA levels.

In the present study, neither prostatic pathology and tPSA nor age and

tPSA were found to be related


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Discussion

In our study, we detected that the risk of AUR was 1,8 times higher in

patients with prostatitis

Tuncel et al. found that the risk of AUR was approximately 3 times

higher in patients with prostatic inflammation

Present study: The duration of catheterization was significantly longer

in the patients with chronic prostatitis than in those with BPH.

However, we were unable to determine if the prostatic inflammation

was the causative pathology leading to AUR or the consequence of

catheterization


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Conclusion

Advanced age (>70 years), a larger prostate (resected prostate volume

>25 g) and the presence of prostatic inflammation were independent

risk factors for the occurrence of AUR, whereas tPSA level was not.


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Prostate-specific antigen (PSA)

Protein produced by normal prostate cells

Prostate epithelial cells & seminal fluid (>>), serum

PSA: prostate cancer

BPH (prostate volume)

acute bacterial prostatitis

Monitoring therapy & tumor regression

PSA levels: 4.0 ng/mL, monitoring (digital rectal examination)

urinary tract infection, BPH, cancer


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Stamey et al: calculate the amount of PSA produced per gram of

benign prostatic tissue.

The PSA level was 0.31 0.25 ng/mL per gram of hyperplastic tissue.

Age prostate volume PSA

Prostate volume increased (inflammation)

AUR

PSA levels

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