Korean J Urol.  2009 Oct;50(10):982-988.

The Risk Factors for Increased Post-Voiding Residual Urine Volume after Long-Term Anticholinergic Therapy in Patients with Benign Prostatic Hyperplasia and Overactive Bladder

Affiliations
  • 1Department of Urology, College of Medicine, Inje University, Gimhae, Korea. ircho@paik.ac.kr

Abstract

PURPOSE
Adding anticholinergics to the treatment regimen of benign prostatic hyperplasia (BPH) patients with overactive bladder (OAB) elicits concern about deterioration of obstructive symptoms and the possibility of urine retention. We evaluated the risk factors increasing post-voiding residual (PVR) volume with long-term anticholinergics therapy of over 1 year in patients with BPH and OAB.
MATERIALS AND METHODS
We selected patients with BPH and OAB from 2005 to 2007 who were more than 40 years old, were treated with alpha-blockers, had an International Prostate Symptom Score (IPSS) of 8 or more, and had an IPSS urgency score of 2 or more for OAB. The 98 patients selected were evaluated by age, diabetes mellitus, central nervous system (CNS) disease above the brain stem, prostate volume, uroflowmetry, PVR volume, prostate-specific antigen (PSA) level, and IPSS retrospectively. We evaluated risk factors for increasing PVR volume over 50 ml and 100 ml after treatment and analyzed the risk factors both univariately and multivariately.
RESULTS
Age, diabetes mellitus, CNS disease, PSA level, prostate volume, initial PVR volume, peak urine flow rate (< or =15 ml/s), use of anticholinergics, and no use of 5-alpha-reductase inhibitor, which were regarded as risk factors for increasing PVR volume, were analyzed for their relation with PVR volume over 50 ml and 100 ml, respectively. Age, initial PVR volume, CNS disease, and use of anticholinergics were significantly associated with an increased PVR volume over 100 ml in the univariate analysis. In multivariate analysis, age, initial PVR volume, CNS disease, and use of anticholinergics remained significantly associated with an increased PVR volume over 100 ml.
CONCLUSIONS
Age (> or=65 years), initial PVR (> or=50 ml), long-term therapy with anticholinergics of over 1 year, and CNS disease appear to be risk factors for increasing PVR volume over 100 ml in patients with BPH and OAB.

Keyword

Prostatic hyperplasia; Overactive bladder; Anticholinergics

MeSH Terms

Brain Stem
Central Nervous System
Central Nervous System Diseases
Cholinergic Antagonists
Diabetes Mellitus
Humans
Multivariate Analysis
Prostate
Prostate-Specific Antigen
Prostatic Hyperplasia
Retention (Psychology)
Retrospective Studies
Risk Factors
Urinary Bladder, Overactive
Cholinergic Antagonists
Prostate-Specific Antigen
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