Mortality Is High in Men with Acute Urinary Retention

Urinary retention may signal the presence of systemic disease.

Surprisingly little is known about long-term outcomes in men who develop acute urinary retention. In this study, investigators analyzed hospital databases to determine 1-year outcomes among 176,046 men (age, 45) hospitalized with first episodes of acute urinary retention.

Overall, one in seven men with spontaneous retention (i.e., a primary diagnosis of acute urinary retention or benign prostatic hyperplasia) and one in four with precipitated retention (all events unrelated to prostatic hyperplasia) died within 1 year of the hospitalization. Mortality increased with age: Among men with spontaneous retention, 1-year mortality was 4% in those aged 45 to 54 and 33% in those aged 85 and older. Among men with precipitated retention, these rates were higher (10% and 45%, respectively). Mortality also increased in patients with comorbid disease. For example, among men aged 75 to 84 (the largest age group) with spontaneous retention, 1-year mortality was 13% for those without comorbidities and 29% for those with comorbidities; again, these rates were higher for men with precipitated retention (18% and 41%, respectively). Compared with the general population, men with acute urinary retention had higher mortality regardless of age or presence of comorbidity.

Comment: Mortality is high in men hospitalized for acute urinary retention and increases with age and comorbidity. These results suggest that, beyond simply treating acute urinary retention, clinicians should be vigilant in assessing for, and treating, comorbid disease in these patients.

— Paul S. Mueller, MD, MPH, FACP

Dr. Mueller is Associate Professor of Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota.

Published in Journal Watch General Medicine December 6, 2007

Citation(s):

Armitage JN et al. Mortality in men admitted to hospital with acute urinary retention: Database analysis. BMJ 2007 Nov 8; [e-pub ahead of print]. (http://dx.doi.org/10.1136/bmj.39377.617269.55)