Predictors of Acute Urine Retention in Patients with Benign Prostatic Hyperplasia

Background: Acute urinary retention(AUR) is a serious consequence of benign prostatic hyperplasia(BPH) that requires prompt medical intervention. Identifying reliable, non-invasive predictors of AUR is crucial for early diagnosis and management. This study investigates the predictive value of clinical and sonographic parameters in assessing the risk of AUR in patients with BPH. Methods: This study included 200 patients aged ≥50 years, all giving a presentation with BPH-related lower urinary tract symptoms(LUTS). Of these, 100 patients had AUR, while the remaining 100 had varying degrees of LUTS without AUR. Clinical evaluations and transrectal ultrasound(TRUS) were performed to assess independent clinical and prostate sonomorphologic parameters as predictors of AUR. Logistic regression was used to identify significant predictors of AUR, and ROC curve analyses were conducted to evaluate the diagnostic accuracy of these predictors. Results: Compared to the LUTS group, patients with AUR had significantly higher age, International Prostate Symptom Score(IPSS), prostate-specific antigen(PSA) levels, total prostate volume(TPV), transitional zone volume(TZV), transitional zone index(TZI), and vesico-urethral angle(VUA) (p < 0.05). Multivariate analysis identified age, IPSS, PSA, TZV, TZI, and VUA as independent predictors of AUR. A predictive model incorporating age >62 years, VUA <90°, and TZI >0.68 demonstrated sensitivity, specificity, overall accuracy, and positive predictive value of 76%, 90%, 83%, and 88.4%, respectively. Conclusion: Prostate sonomorphological parameters and clinical factors like age; IPSS; PSA predict AUR in BPH patients; allowing for timely intervention to reduce catheterization and surgery.