Impact of COVID‐19 pandemic on lower urinary tract symptoms in patients with benign prostatic hyperplasia and predictors of urine retention in such patients

Abstract

Objectives We assess the effect of coronavirus disease 2019 (COVID‐19) on lower urinary tract symptoms (LUTS) of patients with benign prostatic hyperplasia (BPH). Moreover, we delineate risk factors for urine retention in such patients. Methods All COVID‐19 infected males were expeditiously evaluated. All enrolled patients were assessed using the International Prostate Symptom Score (IPSS), uroflowmetry, and pelvi‐abdominal ultrasonography for prostate volume and postvoiding residual urine (PVR) estimation. Results Fifty patients, who were diagnosed with BPH, were enrolled. The mean age (±SD) was 62.64 ± 7.69. In the pre‐ and post‐COVID‐19 group, the mean (±SD) IPSS was 13.42 ± 4.32 and 26.62 ± 5.77, respectively (P < .001), while PVR was 90.40 ± 32.75 and 185.42 ± 73.42, respectively (P < .001), and maximum flow rate was 14.40 ± 2.75 and 10.74 ± 3.43, respectively (P < .004). After infection with COVID‐19, 13 (26%) patients were managed by urethral catheter fixation owing to urine retention. On bivariate analysis, age, diabetes, large prostate on digital rectal examination, alpha‐blocker monotherapy, microscopic hematuria, positive urine culture, and pre‐COVID‐19 IPSS were significantly correlated with urine retention (P < .001, P = .01, P < .001, P = .06, P < .001, P = .04, and P < .001, respectively). On multivariate analysis, age, pre‐COVID‐19 IPSS, and positive urine culture were the independent predictors of urine retention (P = .05, P < .001, and P = .01, respectively). Conclusion LUTS in BPH patients were significantly affected by COVID‐19. COVID‐19 increases IPSS leading to a change in the treatment modality of BPH. On multivariate analysis, age, pre‐COVID‐19 IPSS, and positive urine culture were the independent predictors of urine retention post COVID‐19 infection.

Urodynamically proven lower urinary tract dysfunction in children after COVID‐19: A case series

“… 9 In this context, some studies in the adult literature report COVID‐19 may cause exacerbation of LUTS in patients with benign prostatic hyperplasia and may even be a predictor of urinary retention. 11 Even an occult meningeal reaction has been reported in an elderly patient, independent of COVID‐19, on the basis of urinary retention of undetermined etiology. 12 This shows that every possibility should be considered in the differential diagnosis.…”

“…Moreover, it has been noted that urinary retention may be originating from febrile systemic infections (eg, viral, enteric, and nonurogenital), albeit to a lesser extent 9 . In this context, some studies in the adult literature report COVID‐19 may cause exacerbation of LUTS in patients with benign prostatic hyperplasia and may even be a predictor of urinary retention 11 . Even an occult meningeal reaction has been reported in an elderly patient, independent of COVID‐19, on the basis of urinary retention of undetermined etiology 12 .…”

Impact of COVID-19 on male urogenital health: Success of vaccines

“… 48 Nabeeh et al indicated that, among men receiving COVID-19 treatment, 13 patients experienced acute urinary retention and required urethral catheters and 15 patients underwent transurethral resection of the prostate. 44 They also noticed that patients requiring intensive care with the complaint of severe respiratory distress had higher IPSSs than patients hospitalized in the ward. 44 Similarly, a different study revealed that COVID-19 patients with high IPSSs had a significantly higher need for intensive care and mortality rates than those with low IPSSs.…”

“…In three patients with the diagnosis of microhematuria, SARS-CoV-2 caused viral cystitis exacerbating local inflammation in urothelial cells which eventually led to irritative LUTS. [43] , [44] Nabeeh et al showed that immunosuppression is associated with increased LUTS, severe pyuria and urinary tract infections. 44 A previous study found increased urinary frequency, as one of the symptoms of COVID-19, in seven out of 57 COVID-19 patients.…”

“… [43] , [44] Nabeeh et al showed that immunosuppression is associated with increased LUTS, severe pyuria and urinary tract infections. 44 A previous study found increased urinary frequency, as one of the symptoms of COVID-19, in seven out of 57 COVID-19 patients. 43 Marand et al showed the existence of white and red blood cells in COVID-19 patient urine; in patients who had no previously diagnosed urinary tract disorders, for example urinary retention, incontinence or LUTS.…”