Development of Benign Prostatic Hyperplasia

Altwein, Jens E.; Baur, H

doi:10.1007/978-3-642-77480-5_1

Cited by 12 publications

(5 citation statements)

References 22 publications

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“…Based on evident literature and anatomical reasoning, it stands to reason that BPH has a higher association with POUR due to mechanical obstruction of urine across the bladder. 23 , 29 Previous studies have also demonstrated substantial association between DM and POUR following diverse general and orthopedic surgical procedures. 26 , 30 , 31 The pathophysiology underlying bladder dysfunction in patients with DM is multi-factorial; and may be attributed to neuropathy, poly-pharmacy, dehydration, and older age.…”

Section: Discussionmentioning

confidence: 96%

Risk Factors for Postoperative Urinary Retention Following Lumbar Spine Surgery: A Review of Current Literature and Meta-Analysis

Reed

Mihas

Fortin

et al. 2022

Global Spine Journal

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Study Design Systematic Review and Meta-analysis Objective Postoperative urinary retention (POUR) is a common complication following lumbar spine surgery (LSS) and timely recognition is imperative to avoid long-term consequences. The aim of the current meta-analysis was to systematically review the literature in order to identify risk factors associated with POUR after LSS. Methods In accordance with PRISMA guidelines, a systematic review of the literature was performed using Pubmed, EMBASE, and MEDLINE database for articles on POUR following LSS. A meta-analysis was performed comparing patients with and without POUR; and the factors associated with this adverse event were analyzed. The pooled data were reported as mean differences with 95% confidence intervals (CI; P < .05). Heterogeneity among the studies was evaluated using the I2 statistic. Results The meta-analysis included 10 studies compromised of 30,300 patients. Based on our analysis, patients who were male, were older in age, underwent instrumented fusion, had diabetes mellitus, coronary artery disease, or benign prostatic hypertrophy had significantly higher risk of developing POUR. Additionally, patients in who developed POUR had significantly longer surgical times and higher volumes of intra-operative fluid administration, as compared with non-POUR patients. The POUR patients also had a significantly higher association with urinary tract infection. Prior surgery, BMI, length of stay, and smoking status did not reveal any statistical association with POUR. Conclusions Risk factors associated with POUR following LSS include male gender, older age, longer surgical times, fusion procedures, larger volumes of intraoperative infusions, and associated comorbidities like DM, CAD, and BPH.

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Section: Discussionmentioning

confidence: 96%

Risk Factors for Postoperative Urinary Retention Following Lumbar Spine Surgery: A Review of Current Literature and Meta-Analysis

Reed

Mihas

Fortin

et al. 2022

Global Spine Journal

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“…Benign prostatic hyperplasia (BPH) is a urologic disease with a high prevalence in males older than 60 years old 2 . The prevalence is greater in white and Afro-American males; however, it tends to be more severe and progressive in Afro-Americans, possibly due to higher testosterone levels, > 5-alpha reductase activity, androgen receptor expression, and growth factor activity in this population 3 . Although multiple inflammatory, hormonal, and environmental factors and lifestyle can predispose to this condition, they have yet to be completely defined 4 .…”

Section: Introductionmentioning

confidence: 94%

Relationship between lower urinary tract symptoms and prostatic anatomic characteristics in patients with obesity and severe obesity

Flores-Aguilar¹,

Olivo-Gárate²,

Montiel-Jarquín³

et al. 2023

CIRUE

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Objective:The objective of the study was to compare lower urinary tract symptoms and prostatic anatomic characteristic with prostatic enlargement in obese patients. Materials and methods: A comparative and cross-sectional study was conducted from October 2018 to November 2018. Lower urinary tract symptoms were compared in patients with body mass index (BMI) To evaluate these symptoms, the International Prostatic Symptom Score (IPSS) was used on 537 patients. The variables were age, weight and size, BMI, prostatic volume measurement by ultrasound, prostate-specific antigen (PSA), and finasteride treatment. Descriptive statistic was used, Cronbach's alpha, Fisher's exact test, and Chi-square. Results: One hundred fulfilled inclusion criteria. Mean values were age 68.73 years, weight 84.98 kg, size 1.61 m, BMI 32.62, ultrasonographic prostatic size was 69.09 cm 3 , and PSA 1.94 ng/dl. The IPSS was severe in 3.6% (Group 1), 17.6% (Group 2); moderate 72% (Group 1), 70.5% (Group 2); and mild 33.3% (Group 1), 11.7% (Group 2), with significant differences between both groups (p = 0.05). Differences between values of prostatic volume and BMI did not show statistical significance (p ≥ 0.05). Conclusion: Statistical association between obesity and severe obesity and lower urinary tract symptoms is positive.

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“…nocturia, urgency, and frequency). 3 Although LUTS does not infer etiology, in men it is often due to BPH. In the United States, BPH/LUTS affects over 15 million men aged 30 and above, 4 leading to a substantial economic burden of over US$3 billion per year.…”

Section: Introductionmentioning

confidence: 99%

Transurethral Resection of the Prostate in Younger Men: Effectiveness and Long-term Outcomes

Malshy,

Eigner,

Ochsner

et al. 2024

Rambam Maimonides Med J

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Objectives: This study aims to investigate the efficacy and outcomes of transurethral resection of the prostate (TURP) in the context of younger male patients. Methods: Males aged ≤55 who underwent TURP at Rambam Health Care Campus from January 2011 to August 2023 were retrospectively reviewed. Clinicodemographic characteristics, indications for surgery, uroflowmetry, pressure-flow study, and early and late postoperative outcomes were collected. Patients with urethral or bladder abnormalities were excluded. Chi-square and Fisher’s exact tests were employed for bivariate analysis. Results: Inclusion criteria were met by 58 men who underwent TURP at a median age of 52 years (interquartile range [IQR] 49.5–54). Median prostate size was 35 mL (24.5–56), with median prostate-specific antigen of 1.4 ng/mL (0.65–3.1). A total of 60% of patients used α-blockers, and 19% used 5α-reductase inhibitors pre-surgery. Overall, 54 (93.1%) had severe lower urinary tract symptoms (LUTS), with 34 (59%) being predominantly emptying and 20 (35%) storage. Most surgeries were performed for refractory LUTS in 38 (66%), followed by urinary retention in 16 (28%). At 6 weeks, 57 (98%) patients were catheter-free. The maximum flow rate and residual volume showed significant improvement from 9 mL/s to 21 mL/s (P=0.01), and from 171 mL to 61 mL (P=0.006), respectively. Pathology revealed benign prostatic hyperplasia in 53 (91.4%), and inflammation in 5 (8.5%). A total of 13 auxiliary procedures were required in 12 patients (20.7%) during follow-up: 7 transurethral bladder neck incisions, 3 re-TURP, 1 meatus widening, and 1 patient required artificial urinary sphincter implantation followed by simple cystectomy for end-stage bladder. Conclusions: In young men, TURP showed short-term gains in flowmetry and catheter removal rates, but a sustained need for subsequent procedures in the long run. In this unique population, patients should be carefully selected, and alternative, less aggressive, interventions should be considered.

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Development of Benign Prostatic Hyperplasia

Cited by 12 publications

References 22 publications

Risk Factors for Postoperative Urinary Retention Following Lumbar Spine Surgery: A Review of Current Literature and Meta-Analysis

Risk Factors for Postoperative Urinary Retention Following Lumbar Spine Surgery: A Review of Current Literature and Meta-Analysis

Relationship between lower urinary tract symptoms and prostatic anatomic characteristics in patients with obesity and severe obesity

Transurethral Resection of the Prostate in Younger Men: Effectiveness and Long-term Outcomes

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