Transurethral resection of the prostate provides more favorable clinical outcomes compared with conservative medical treatment in patients with urinary retention caused by benign prostatic obstruction.
BACKGROUND
To evaluate the long-term surgical outcomes of patients with urinary retention (UR) caused by a benign prostatic obstruction (BPO) who underwent transurethral resection of the prostate (TURP), and compare their outcomes with those of patients who received medication without surgical intervention.


METHODS
This retrospective cohort study analyzed claims data collected during the period of 1997-2012 from Taiwan's National Health Insurance Research Database. We examined geriatric adverse events among patients who had received a diagnosis of symptomatic benign prostatic hyperplasia and whom experienced UR, and compared those who received TURP and medication only. Primary outcomes included urinary tract infection (UTI), UR, inguinal hernia, hemorrhoids, stroke, acute myocardial infarction, and bony fracture. We excluded patients who had concomitant prostate cancer, bladder cancer, or a long-term urinary catheter indwelling, as well as those who did not receive α-blocker medication regularly. Those aged <50 or >90 years were also excluded. The enrolled patients were categorized into TURP (n = 1218) and medication only (n = 795) groups. After 1:1 propensity score matching, we recorded and compared patients' characteristics, postoperative clinical outcomes, and geriatric adverse events.


RESULTS
The TURP cohort had a lower incidence of UTI and UR during the postoperative follow-up period from 2 months to 3 years than did the medication only group (20.7% vs. 28.9% and 12.5% vs. 27.6%, respectively, p < 0.001). The life-long bone fracture incidence was also lower in the TURP cohort (7.9% vs. 9.2%, p = 0.048). The incidence of other outcomes during the postoperative follow-up period did not differ between the two groups.


CONCLUSIONS
Compared with conservative treatment, TURP provides more favorable clinical outcomes in patients with UR caused by BPO. Patients who underwent TURP had a lower risk of UTI, repeat UR episodes, and emergent bony fracture. Thus, early surgical intervention should be considered for such patients.
['Lin|Yu-Hsiang|YH|', 'Hou|Chen-Pang|CP|', 'Chen|Tien-Hsing|TH|', 'Juang|Horng-Heng|HH|', 'Chang|Phei-Lang|PL|', 'Yang|Pei-Shan|PS|', 'Chen|Chien-Lun|CL|', 'Tsui|Ke-Hung|KH|']
D000368:Aged D000072700:Conservative Treatment D006801:Humans D015994:Incidence D008297:Male D008875:Middle Aged D010043:Outcome and Process Assessment, Health Care D011470:Prostatic Hyperplasia D012189:Retrospective Studies D013624:Taiwan D020728:Transurethral Resection of Prostate D016896:Treatment Outcome D016055:Urinary Retention
Outcome Benign prostate hyperplasia Alfa-blocker Prostatectomy Urine retention