Incontinence Related to Management of Benign Prostatic Hypertrophy

Euna Han, Libby K. Black, John P. Lavelle

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Background: The prevalence of incontinence ranges from 11% to 34% among community-dwelling men aged ≥65 years. Objective: The objective of this analysis was to determine the nature of incontinence diagnosed in men with benign prostatic hypertrophy (BPH), focusing on its incidence, prevalence, diagnostic workup, and management. Methods: A cohort of patients with BPH was identified in the Integrated Healthcare Information Services National Managed Care Benchmark Database (1997-2003). Age and duration in the database after the first diagnosis of BPH were used as matching strata. Therapeutic subgroups consisted of watchful waiting, g-blockers, 5-α-reductase inhibitors (5ARIs), and BPH-related surgery. Results: A total of 411,658 males with BPH were identified from 12,298,027 males (3.3%). Of the BPH cohort, 2.7% (n = 11,172) were identified as having incontinence; of these, 57.8% of patients were ≥65 years of age. Alter applying inclusion/exclusion criteria, the final matched case-control sample included 6346 men as case subjects and 229,154 men as control subjects. The overall incidence of incontinence in this BPH sample was 1835/100,000/year, and the prevalence was 2713/100,000 men. In 48.5% of the incontinent men, the type of incontinence was not specified. Diagnostic testing was performed in 2.9% of men with incontinence. Conditional logistic regression analyses found that BPH-related surgery and g-blocker use increased the adjusted odds ratio for the risk of incontinence 3.1-fold, and 1.1- to 1.7-fold, respectively. The odds ratio of the risk of incontinence was not significantly increased with long-term 5ARI use. Condusions: Use of g-blockers, 5ARIs for the short term (<1 year), and BPH-related surgery were independently, significantly associated with BPH-related incontinence; 5ARI use for >1 year and watchful waiting were not. BPH-related incontinence may be related to progression of BPH or as a postsurgical complication. Patients with BPH should be asked specifically about incontinence, especially after BPH-related surgery, and undergo a full diagnostic workup for the diagnosis of urinary incontinence.

Original languageEnglish
Pages (from-to)324-334
Number of pages11
JournalAmerican Journal Geriatric Pharmacotherapy
Volume5
Issue number4
DOIs
Publication statusPublished - 2007 Dec 1

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Prostatic Hyperplasia
Watchful Waiting
Odds Ratio
Databases
Independent Living
Benchmarking
Information Services
Incidence
Urinary Incontinence
Managed Care Programs
Oxidoreductases
Logistic Models
Regression Analysis
Delivery of Health Care

All Science Journal Classification (ASJC) codes

  • Geriatrics and Gerontology
  • Pharmacology (medical)

Cite this

Han, Euna ; Black, Libby K. ; Lavelle, John P. / Incontinence Related to Management of Benign Prostatic Hypertrophy. In: American Journal Geriatric Pharmacotherapy. 2007 ; Vol. 5, No. 4. pp. 324-334.
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abstract = "Background: The prevalence of incontinence ranges from 11{\%} to 34{\%} among community-dwelling men aged ≥65 years. Objective: The objective of this analysis was to determine the nature of incontinence diagnosed in men with benign prostatic hypertrophy (BPH), focusing on its incidence, prevalence, diagnostic workup, and management. Methods: A cohort of patients with BPH was identified in the Integrated Healthcare Information Services National Managed Care Benchmark Database (1997-2003). Age and duration in the database after the first diagnosis of BPH were used as matching strata. Therapeutic subgroups consisted of watchful waiting, g-blockers, 5-α-reductase inhibitors (5ARIs), and BPH-related surgery. Results: A total of 411,658 males with BPH were identified from 12,298,027 males (3.3{\%}). Of the BPH cohort, 2.7{\%} (n = 11,172) were identified as having incontinence; of these, 57.8{\%} of patients were ≥65 years of age. Alter applying inclusion/exclusion criteria, the final matched case-control sample included 6346 men as case subjects and 229,154 men as control subjects. The overall incidence of incontinence in this BPH sample was 1835/100,000/year, and the prevalence was 2713/100,000 men. In 48.5{\%} of the incontinent men, the type of incontinence was not specified. Diagnostic testing was performed in 2.9{\%} of men with incontinence. Conditional logistic regression analyses found that BPH-related surgery and g-blocker use increased the adjusted odds ratio for the risk of incontinence 3.1-fold, and 1.1- to 1.7-fold, respectively. The odds ratio of the risk of incontinence was not significantly increased with long-term 5ARI use. Condusions: Use of g-blockers, 5ARIs for the short term (<1 year), and BPH-related surgery were independently, significantly associated with BPH-related incontinence; 5ARI use for >1 year and watchful waiting were not. BPH-related incontinence may be related to progression of BPH or as a postsurgical complication. Patients with BPH should be asked specifically about incontinence, especially after BPH-related surgery, and undergo a full diagnostic workup for the diagnosis of urinary incontinence.",
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Incontinence Related to Management of Benign Prostatic Hypertrophy. / Han, Euna; Black, Libby K.; Lavelle, John P.

In: American Journal Geriatric Pharmacotherapy, Vol. 5, No. 4, 01.12.2007, p. 324-334.

Research output: Contribution to journalArticle

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N2 - Background: The prevalence of incontinence ranges from 11% to 34% among community-dwelling men aged ≥65 years. Objective: The objective of this analysis was to determine the nature of incontinence diagnosed in men with benign prostatic hypertrophy (BPH), focusing on its incidence, prevalence, diagnostic workup, and management. Methods: A cohort of patients with BPH was identified in the Integrated Healthcare Information Services National Managed Care Benchmark Database (1997-2003). Age and duration in the database after the first diagnosis of BPH were used as matching strata. Therapeutic subgroups consisted of watchful waiting, g-blockers, 5-α-reductase inhibitors (5ARIs), and BPH-related surgery. Results: A total of 411,658 males with BPH were identified from 12,298,027 males (3.3%). Of the BPH cohort, 2.7% (n = 11,172) were identified as having incontinence; of these, 57.8% of patients were ≥65 years of age. Alter applying inclusion/exclusion criteria, the final matched case-control sample included 6346 men as case subjects and 229,154 men as control subjects. The overall incidence of incontinence in this BPH sample was 1835/100,000/year, and the prevalence was 2713/100,000 men. In 48.5% of the incontinent men, the type of incontinence was not specified. Diagnostic testing was performed in 2.9% of men with incontinence. Conditional logistic regression analyses found that BPH-related surgery and g-blocker use increased the adjusted odds ratio for the risk of incontinence 3.1-fold, and 1.1- to 1.7-fold, respectively. The odds ratio of the risk of incontinence was not significantly increased with long-term 5ARI use. Condusions: Use of g-blockers, 5ARIs for the short term (<1 year), and BPH-related surgery were independently, significantly associated with BPH-related incontinence; 5ARI use for >1 year and watchful waiting were not. BPH-related incontinence may be related to progression of BPH or as a postsurgical complication. Patients with BPH should be asked specifically about incontinence, especially after BPH-related surgery, and undergo a full diagnostic workup for the diagnosis of urinary incontinence.

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