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Acute urinary retention: medical management and the identification of risk factors for prevention

Nature Clinical Practice Urology volume 4, pages 422–431 (2007)Cite this article

Abstract

Male lower urinary tract symptoms associated with benign prostatic hyperplasia can be progressive in some patients and lead to adverse consequences such as acute urinary retention (AUR), which might require prostate surgery. This Review identifies baseline and dynamic variables that have been recognized as risk factors that might predispose men to AUR. Evidence for the use of medical therapy to reduce the risk of benign prostatic hyperplasia progression, which might prevent AUR, has been critically evaluated. The literature describing the pharmacological management of men with AUR, and in those who have successfully voided after removal of a catheter, has been critically appraised in this article.

Key Points

  • Benign prostatic hyperplasia can be progressive and lead to adverse events; risk factors for progression can be assessed to help identify men at risk of acute urinary retention and those who might have recurrence of retention following successful initial medical management

  • Men at risk of disease progression without bothersome symptoms are best treated with 5α-reductase inhibitors alone

  • Men who experience bothersome symptoms without other risk factors for disease progression are best treated with α-blockers alone

  • Individuals who have both risk of disease progression and bothersome symptoms should be prescribed combination therapy

  • α-Blockers increase the chances of successful voiding after removal of the catheter following acute urinary retention

  • Continuing α-blocker therapy after catheter removal for acute urinary retention reduces the risk of relapse in the short term; careful monitoring of dynamic variables during this period allows for the identification of men likely to benefit most from surgery

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Author information

Authors and Affiliations

  1. J Khastgir is a Senior Specialist Registrar in Urology and A Khan is a Research Fellow in Urology at the Bristol Urological Institute, Southmead Hospital, Bristol, UK.,

    Jay Khastgir & Azhar Khan

  2. M Speakman is a Consultant Urologist at the Musgrove Park Hospital, Taunton, Somerset, UK.,

    Mark Speakman

Authors
  1. Jay Khastgir
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  2. Azhar Khan
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  3. Mark Speakman
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Corresponding author

Correspondence to Jay Khastgir.

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The authors declare no competing financial interests.

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Khastgir, J., Khan, A. & Speakman, M. Acute urinary retention: medical management and the identification of risk factors for prevention. Nat Rev Urol 4, 422–431 (2007). https://doi.org/10.1038/ncpuro0860

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  • DOI: https://doi.org/10.1038/ncpuro0860

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