最大尿流速小於15ml/sec 真的會增加尿滯留的風險嗎?
謝登富、劉昕和、林殿璜、李祥生、蔡宗訓、陳至正
台中慈濟醫院泌尿科；花蓮慈濟大學醫院
Is maximum urine flow rate of less than 15ml/sec a risk factor of urine retention
Teng-Fu Hsieh, Hsin-Ho Liu, Tien-Huang Lin, Shang-Sen Lee, Tsung-Hsun Tsai, Chi-Cheng Chen
Department of Urology, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan；School of Medicine, Tzu Chi University, Hualian, Taiwan
Purpose: The aim of this study is to investigate the risk of urine retention in patients with maximum urine flow rate of less than 15ml/sec using the National Health Insurance Research Database (NHIRD) in Taiwan.
Materials and Methods: In total, 303 adult patients newly diagnosed with maximum urine flow rate of less than 15ml/sec were recruited as the study group cohort, along with 1,212 subjects who have maximum urine flow rate of more than 15ml/sec as a control group between 1 January, 2002 to 31 December, 2011. Each patient was monitored to identify those who subsequently developed urine retention or prostate surgery. A Cox proportional hazards model was used to compare the risk of urine retention or prostate surgery between the study and comparison cohorts after adjusting for possible confounding risk factors.
Results: Patients who had maximum urine flow rate of less than 15ml/sec had a higher cumulative rate of urine retention or prostate surgery than those who did not (8.3% vs. 5.9%, p=0.003). Compared with the control group, there was increase in the risk of prostate surgery and acute urine retention in the study group (HR=1.83, 95% CI: 1.16 to 2.91) after adjusting for age, comorbidities, geographic region and socioeconomic status.
Conclusion: Maximum urine flow rate of less than 15ml/sec is a risk factor of urinary retention and subsequent prostate surgery in BPH patients receiving alpha-1 blocker therapy. Further mechanistic research is warranted to validate the results.