Natural history of prostatism: Risk factors for acute urinary retention
Natural history of prostatism: Risk factors for acute urinary retention
复制标题
DOI：
10.1016/s0022-5347(01)64508-7
复制
发表时间：
1997-08-01
影响因子：
6.6
通讯作者：
Lieber, MM
中科院分区：
文献类型：
--
作者：
Jacobsen, SJ;Jacobson, DJ;Lieber, MM
目的：我们确定急性尿潴留在社区环境中的发生和危险因素。材料和方法：从明尼苏达州奥姆斯特德县的人口中随机抽取了2115名40至79岁的男性（应答率55%）。参与者完成先前验证的基线问卷，评估症状严重程度，并使用便携式尿尿计测量峰值尿流率。随机抽取25%的亚样本进行经直肠前列腺超声成像以确定前列腺体积。通过回顾性审查社区医疗记录进行随访，以确定随后4年内急性尿潴留的发生情况。结果：在8344人-年的随访中，57名男性首次出现急性尿潴留（发病率6.8/ 1000人-年，95%可信区间[CI] 5.2, 8.9）。在无症状至轻度症状（美国泌尿协会症状指数评分为7分或以下）的男性中，急性尿潴留的发生率从40至49岁男性的2.6/ 1000人年增加到70至79岁男性的9.3/ 1000人年。相比之下，在有中重度症状（美国泌尿协会症状指数评分大于7）的男性中，发病率从40至49岁男性的3.0/ 1000人年增加到70至79岁男性的34.7/ 1000人年。峰值尿流率低的男性（小于每秒12毫升）发生急性尿潴留的风险是尿流率大于每秒12毫升的男性的4倍（95% CI 2.3, 6.6）。前列腺肥大（大于30毫升）的男性的风险增加了3倍（95% CI 1.0, 9.0, p = 0.04）。结论：下尿路症状、峰值尿流率下降、前列腺肥大和年龄增大与社区男性急性尿潴留的风险增加有关。这些发现可能有助于识别急性尿潴留风险增加的男性，他们可能需要更密切的评估。
Purpose: We determined the occurrence of and risk factors for acute urinary retention in the community setting.Materials and Methods: A cohort of 2,115 men 40 to 79 years old was randomly selected from an enumeration of the Olmsted County, Minnesota population (55% response rate). Participants completed a previously validated baseline questionnaire that assessed symptom severity, and voided into a portable urometer to measure peak urinary flow rates. A 25% random subsample underwent transrectal sonographic imaging of the prostate to determine prostate volume. Follow-up was performed through a retrospective review of community medical records to determine the occurrence of acute urinary retention in the subsequent 4 years.Results: During the 8,344 person-years of followup 57 men had a first episode of acute urinary retention (incidence 6.8/1,000 person-years, 95% confidence interval [CI] 5.2, 8.9). Among men with no to mild symptoms (American Urological Association symptom index score 7 or less) the incidence of acute urinary retention increased from 2.6/1,000 person-years among men 40 to 49 years old to 9.3/1,000 person-years among men 70 to 79 years old. By contrast, rates increased from 3.0/1,000 person-years for men 40 to 49 years old to 34.7/1,000 person-years among men 70 to 79 years old among men with moderate to severe symptoms (American Urological Association symptom index score greater than 7). Men with depressed peak urinary flow rate (less than 12 ml. per second) were at 4 times the risk of acute urinary retention compared with men with urinary flow rates greater than 12 ml. per second (95% CI 2.3, 6.6). Men with an enlarged prostate (greater than 30 ml.) experienced a 3-fold increase in risk (95% CI 1.0, 9.0, p = 0.04).Conclusions: Lower urinary tract symptoms, depressed peak urinary flow rates, enlarged prostates and older age are associated with an increased risk of acute urinary retention in community dwelling men. These findings may help to identify men at increased risk of acute urinary retention in whom closer evaluation may be warranted.