Long-Term Aspects of Medical Treatment of BPH

The economic impact of using alfuzosin 10 mg once daily in the management of acute urinary retention in the UK: a 6‐month analysis

“…Acute urinary retention (AUR) is a common complication of ageing men with BPH. Risk factors for AUR include old age, increased prostate volume, postvoid residual volume, severe LUTS and reduced peak urinary flow rate [1,2]. Reported incidence rates of AUR vary widely, at 0.4–25% per year in men seen in urological practice [2].…”

“…Risk factors for AUR include old age, increased prostate volume, postvoid residual volume, severe LUTS and reduced peak urinary flow rate [1,2]. Reported incidence rates of AUR vary widely, at 0.4–25% per year in men seen in urological practice [2]. From a large cohort of 2115 community‐dwelling men aged 40–79 years in Minnesota (USA), it was estimated that a 60‐year‐old man had a 23% probability of experiencing an episode of AUR if he survived another 20 years [3].…”

“…α 1 ‐blockers have been shown to increase the success rate of TWOC in patients presenting with AUR [6,7]; by reducing sympathetic tone, they reduce bladder outlet resistance and postvoid residual urine, two factors important in the development of AUR [2]. There is a greater morbidity and mortality associated with emergency surgery after AUR [2,9], and therefore any treatment that increases the success rate of a TWOC should be of benefit. Alfuzosin is a uroselective α 1 ‐blocker that may be used in the medical management of AUR.…”

Who Would Benefit from Solifenacin Add‐On Therapy to Tamsulosin for Overactive Bladder Symptoms Associated with Benign Prostatic Hyperplasia?

“…The main objective of treating BPH and resulting BOO is primarily to provide a rapid and sustained improvement in LUTS and to diminish the long‐term complications of the disease, such as acute urinary retention . It is generally accepted that storage symptoms are more bothersome to the patient and significantly affect QOL as measured by appropriate questionnaires .…”

Smoking and acute urinary retention: The Olmsted County study of urinary symptoms and health status among men

“…In fact, many have suggested that this inverse relationship may be due to a bias imposed by smokers being perceived as generally poorer surgical candidates, resulting in proportionately fewer procedures among smokers as compared to non-smokers [4,5]. However, smoking could affect risk of BPH through either neurologic or endocrine pathways [6]; either of these may affect a man's risk of acute urinary retention (AUR), often an indicator of advanced disease and trigger for surgical therapy [7,8]. We therefore hypothesized that an inverse relationship between smoking and AUR may be responsible for some portion of the inverse relationship between smoking and surgery for BPH.…”