S. H. Ho Urology Centre, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China.
Division of Biostatistics, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China.
Asian J Androl. 2019 Sep-Oct;21(5):468-472. doi: 10.4103/aja.aja_101_18.
It is largely unknown whether lower urinary tract symptoms (LUTS) or acute retention of urine (AROU) is linked to shorter life expectancy in men. We conducted a multicenter, retrospective database analysis of patients undergoing transurethral resection of prostate (TURP) to study their relationships. Multivariate Cox regression analysis and Kaplan-Meier analysis with stratification to age and indication of TURP were performed. We further performed an age- and sex-matched survival analysis with the general population using data from the Census and Statistics Department of the Hong Kong Special Administrative Region (Hong Kong, China). From January 2002 to December 2012, 3496 patients undergoing TURP were included in our study, with 1764 patients in the LUTS group and 1732 patients in the AROU group. Old age, ischemic heart disease, cerebrovascular accident, and AROU were risk factors of mortality. Patients aged <70 years (adjusted hazard ratio [HR]: 1.52, 95% confidence interval [CI]: 1.11-2.09, P = 0.010) and 70-80 years (adjusted HR: 1.39, 95% CI: 1.15-1.70, P = 0.001) in the AROU group had worse survival than those in the LUTS group, but such difference was not demonstrated in patients aged >80 years. Compared to the general population, younger patients in the LUTS group appeared to have better survival (<70 years, P = 0.091; 70-80 years, P = 0.011), but younger patients in the AROU group had worse survival (<70 years, P = 0.021; 70-80 years, P = 0.003). For patients aged >80 years, survival was similar with the general population in both the LUTS and AROU groups. In conclusion, AROU at young age was associated with mortality, while early detection and management of LUTS may improve survival.
目前尚不清楚下尿路症状（LUTS）或急性尿潴留（AROU）是否与男性预期寿命缩短有关。我们对接受经尿道前列腺切除术（TURP）的患者进行了多中心回顾性数据库分析，以研究它们之间的关系。进行了多变量 Cox 回归分析和 Kaplan-Meier 分析，并按年龄和 TURP 适应证进行分层。我们还使用中国香港特别行政区（香港）政府统计处的数据，对一般人群进行了年龄和性别匹配的生存分析。从 2002 年 1 月至 2012 年 12 月，我们的研究纳入了 3496 例接受 TURP 的患者，其中 LUTS 组 1764 例，AROU 组 1732 例。年龄较大、缺血性心脏病、脑血管意外和 AROU 是死亡的危险因素。年龄<70 岁（调整后的危险比[HR]：1.52，95%置信区间[CI]：1.11-2.09，P=0.010）和 70-80 岁（调整后的 HR：1.39，95%CI：1.15-1.70，P=0.001）的 AROU 组患者的生存率低于 LUTS 组，但在年龄>80 岁的患者中未显示出这种差异。与一般人群相比，LUTS 组的年轻患者似乎有更好的生存（<70 岁，P=0.091；70-80 岁，P=0.011），但 AROU 组的年轻患者生存较差（<70 岁，P=0.021；70-80 岁，P=0.003）。对于年龄>80 岁的患者，LUTS 和 AROU 组的生存率与一般人群相似。总之，年轻时发生 AROU 与死亡率相关，而早期检测和管理 LUTS 可能会改善生存。
