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

Abstract

Background-Previous reports have suggested an inverse relationship between smoking and surgery for benign prostatic hyperplasia (BPH). We hypothesized that acute urinary retention (AUR), an adverse outcome of this disease and indication for surgical treatment, may be related to smoking.

Smoking habits and benign prostatic hyperplasia

“…After detailed evaluation, 19 more studies were excluded: 2 for absence of data on incidence rate of BPH, 4 for lack of detailed data, 2 for inclusion of prostatic cancer, 2 for lack of clear inclusive smoking criteria, 6 for insufficient details on BPH diagnosis criteria, 2 which applied an informal scoring system for LUTS, and 1 that contained a calculation error. Finally, 8 eligible studies [ 11 12 13 14 15 16 17 18 ] were identified totally, including 6 cohort studies, 1 case–control study, and 1 cross-sectional study. Of the final studies, 5 were conducted in United States, 1 in Europe, 1 was in Australia, and 1 lacks identification of the study area.…”

“…In spite of the existing basic evidence, our meta-analysis does not indicate the resulting effects’ presence in BPH, while the negative effect of smoking may truly influence the perioperative performance in BPH or the advent of LUTS. Furthermore, only 2 articles present the data for prostatic volume in their study[ 16 30 ] and none of them shows a significant difference in prostatic volumes of smokers compared with never-smokers. Adversely, Plaz et al present their conclusion that smoking decreases prostate enlargement to a degree and even argue for a protective effect of smoking against prostate enlargement.…”

“…In fact, some other studies have observed that smoking decreases acute postoperative urine retention rate. [16] In this way, smoking elevates the bladder activity through sympathetic nervous system and may potentially aggravate over active bladder symptoms. It is also probably because of the autonomic muscle relaxation caused by nicotine with the first sphincter being autonomic.…”

Acute urinary retention and risk of cancer: population based Danish cohort study

“…Also, a US study from Olmsted County in Minnesota found that men who were current smokers had a slightly reduced risk of acute urinary retention (relative risk 0.78, 95% confidence interval 0.41 to 1.49) compared with non-smokers. 22 Thus patients with acute urinary retention are not expected to have higher rates of smoking compared with the general population. In addition, we analysed data categorising the acute urinary retention cohort according to whether or not comorbidities were recorded and we observed an excess risk of cancer among patients without comorbidities who would likely have a lower prevalence of smoking and other adverse lifestyle factors compared with patients with recorded comorbidities.…”

“…For the cancers that occurred later during follow-up, lifestyle factors could be potential confounders, although our finding of a lack of any substantial increase in excess cancer risk disproves the presence of substantial residual confounding. Also, a US study from Olmsted County in Minnesota found that men who were current smokers had a slightly reduced risk of acute urinary retention (relative risk 0.78, 95% confidence interval 0.41 to 1.49) compared with non-smokers 22. Thus patients with acute urinary retention are not expected to have higher rates of smoking compared with the general population.…”