South African Family Practice

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Comparison of men with acute versus chronic urinary retention: aetiology, clinical features and complications

SPJ Van Vuuren, CF Heyns, AD Zarrabi


Background: The objectives were to investigate the aetiology and clinical features of urinary retention and to analyse differences between acute urinary retention (AUR) and chronic urinary retention (CUR).
Method: We analysed the clinical data of 558 men admitted to our institution with urinary retention between September 1998 and June 2007.Statistical analysis was performed with Student’s t-test, Mann-Whitney and Fisher’s exact tests, where appropriate.
Results: The mean age of the men was 66.4 years (range 12.8–94.7). AUR was present in 90.7% and CUR in 9.3%. The most common causes were benign prostatic hyperplasia in 36.6%, adenocarcinoma of the prostate (ACP) in 36.0% and urethral stricture in 14.3%. Mean prostate volume was 56.6 cc (range 15–262). Comparing the groups with AUR versus CUR, a positive urine culture was significantly more common in the group with AUR (34.1% vs. 8%), whereas anaemia (15.9% vs. 34.1%), renal failure (9.1% vs. 46.2%) and hydronephrosis (23.9% vs. 53.9%) were significantly more common in the group with CUR. There was no significant difference in prostate volume or the proportion of men with histological prostatitis (29.5% vs. 23.1%).
Conclusion: The prevalence of ACP and urethral stricture as aetiology of retention was higher than reported in the literature. The prevalence of anaemia, renal failure and hydronephrosis was significantly greater in patients with CUR compared to AUR. There was no significant difference in prostate volume or the prevalence of histological prostatitis, indicating that factors other than prostate size or histological prostatitis determine the development of AUR rather than CUR.

Keywords: urine, retention, prostate, urethra, stricture
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