The incidence of acute urinary retention secondary to BPH is increasing among California men.

Background: Current epidemiological patterns of adverse events of clinical BPH remain unclear. We investigated trends in acute urinary retention (AUR) associated with BPH in a large, population-based cohort.

Methods: We utilized the California Office of Statewide Health Planning and Development Database to examine 3 724 016 emergency room (ER) visits in California among men aged  50 years from 2007 to 2010. Outcomes included AUR for which BPH was the primary diagnosis, AUR for which BPH was a secondary diagnosis and urethral catheterization for AUR. We generated adjusted odds ratios (ORadj) using multivariate logistic regression to determine longitudinal trends.

Results: A total of 17 023 men presented with a diagnosis of BPH-associated AUR, the unadjusted incidence of which increased from 4.00 per 1000 ER visits in 2007 to 5.23 per 1000 ER visits in 2010 (P<0.001). In adjusted analyses, primary AUR (ORadj=1.25; 95% confidence interval (CI), 1.19-1.32; P<0.001) and secondary AUR (ORadj=1.80; 95% CI, 1.62-2.00; P<0.001) increased 25% and 80%, respectively. Urethral catheterization for primary (ORadj=1.30; 95% CI, 1.22-1.39; P<0.001) and secondary (ORadj=1.82; 95% CI, 1.57-2.11; P<0.001) AUR increased 30% and 82%, respectively. Asian race (P<0.001), Hispanic race (P<0.001) and commercial insurance (P<0.001) were associated with significantly increased risks of AUR and urethral catheterization.

Conclusions: Between 2007 and 2010, the observed incidence of BPH-associated AUR increased substantially in a large and ethnically diverse male population of the United States.