A study on acute urinary retention in patients with benign prostatic hyperplasia at a rural setup

Jagadeeswar Addepalli, Balasubramanya K S, John M. Francis, Karthik Thanneru


Background: Acute urinary retention (AUR) is one of the most significant complications of benign prostatic hyperplasia (BPH). Aim was to discuss the management of AUR in BPH in a rural setup.

Methods: It was a prospective study, at PESIMSR, Kuppam, on 100 BPH patients who presented to the ER or OPD with AUR from November 2016 to June 2018. All were catheterized initially. Patient clinical characteristics, prostate size, type of AUR and management one (type of catheterization, hospitalization, trial without catheterisation (TWOC), use of medication, immediate and elective surgery) were recorded.

Results: Mean age was 68.33±9.1. Most patients (74 %) had spontaneous AUR and rest had precipitating factors. A per-urethral catheter (PUC) was inserted in most cases (96%), rest had supra-pubic cystostomy (SPC). Patients with prostate volume of <30 ml (n=8) were started on alpha-blocker (AB) alone and those with >30 ml were given AB with 5 alpha-reductase inhibitor (ARI) combination. TWOC had an overall success rate of 72% (n=72), of them 38 opted for elective surgery. TWOC failed in 28 patients who were re-catheterized and underwent transurethral resection of prostate (TURP) on an elective basis. 66 out of 100 patients underwent TURP in the course of management of AUR in BPH.

Conclusions: Management of AUR in BPH patients in real-life practice in a rural setup hospital has been evaluated. It shows that urethral catheterization, medication, TWOC and finally continuing medical management or planning TURP based has become standard practice.



Full Text:



Emberton M. Acute urinary retention in men: an age old problem. BMJ. 1999;318:921-5.

Thomas K, Oades G, Taylor-Hay C, Kirby RS. Acute urinary retention: what is the impact on patients’ quality of life? BJU Int. 2005;95:72-6.

Jacobsen SJ, Jacobsen DJ, Girman CJ, Roberts RO, Rhodes T, Guess HA, Lieber MM. Natural history of prostatism: risk factors for acute urinary retention. J Urol. 1997;158:481-7.

Meigs JB, Barry MJ, Giovannucci E Rimm EB, Stampfer MJ, Kawachi I. Incidence rates and risk factors for acute urinary retention: the health professionals follow-up study. J Urol. 1999;162:376-82.

Pickard R, Emberton M, Neal DE, on behalf of the National Prostatectomy Audit Steering Group. The management of men with acute urinary retention. Br J Urol. 1998;81:712-20.

Murray K, Massey A, Feneley RC. Acute urinary retention-a urodynamic assessment. Br J Urol. 1984;56:468-73.

Manikandnan R, Srirangam SJ, O’Reily PH, Collins GN. Management of cute urinary retention secondary to benign prostatic hyperplasia in the UK; national survey. BJU Int. 2004;93:84-8.

Desgrandchamps F, De la Taille A, Doublet J. Management of acute urinary retention in France: a cross-sectional survey in 2618 men with benign prostatic hyperplasia. BJU Int. 2006;97:727-33.

Elhilali M, Vallancien G, Emberton M. Management of acute urinary retention (AUR) in patients with BPH. a worldwide comparison. J Urol. 2004;171 (Suppl.):407.

Izard J, N ickel JC. Impact of medical therapy on transurethral resection of the prostaste: two decdes of change. BJU Int. 2011;108:89-93.

Murray K, Massey A, Feneley RC. Acute urinary retention - an urodynamic assessment. Br J Urol. 1984;56:468-73.

Cathcart P, van der Meulen J, Armitage J, Emberton M. Incidence of primary and recurrent acute urinary retention between 1998 and 2003 in England. J Urol. 2006;176:200-4.

Roehrborn CG. Acute urinary retention: risks and management. Rev Urol. 2005;7(4):31-41.

Muruganandham K, Dubey D, Kapoor R. Acute urinary retention in benign prostatic hyperplasia: Risk factors and current management. Indian J Urol. 2007;23(4):347-53.

Lepor H. managing and preventing acute urinary retention. Rev Urol. 2005;7(8):26-33.

Tuncel A, Uzun B, Eruyar T, Karabulut E, Seckin S, Atan A. Do prostatic infarction, prostatic inflammation and prostate morphology play a role in acute urinary retention? Eur Urol. 2005;48(2):277-83.

Aliasgari M, Soleimani M, Moghaddam HSM. The effect of acute urinary retention on serum prostatespecific antigen level. Urol J. 2005;2(2):89-92.

Hua LX, Wu HF, Sui YG, Cheng SG, Xu ZQ. The effect of acute urinary retention on serum prostate specific antigen concentration. National J Androl. 2002;8(2):134-5.

Sagnier PP, McFarlane G, Teillac P, Botto H, Richard F, Boyle P. Impact of symptoms of prostatism on level of bother and quality of life of men in the French community. J Urol. 1995;15:669-73.