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. 1989 Jan 21;298(6667):156–159. doi: 10.1136/bmj.298.6667.156

Late renal failure due to prostatic outflow obstruction: a preventable disease.

S H Sacks 1, S A Aparicio 1, A Bevan 1, D O Oliver 1, E J Will 1, A M Davison 1
PMCID: PMC1835497  PMID: 2466506

Abstract

Nineteen patients presenting with late renal failure due to prostatic outflow obstruction (mean age 68.7 years; mean serum creatinine concentration 1158 mumol/l) were identified from the admission records of two renal units. As late renal failure secondary to prostatic enlargement is preventable case records were analysed retrospectively in an attempt to identify aspects of management in which preventive efforts might be of value. Delays in referral were common, with a mean of 2.8 years between the onset of prostatic symptoms and time of referral, six patients being referred who had had symptoms for more than three years. Four of five patients who had had a prostatectomy were known to be in renal failure at the time of operation but were not referred until 2-13 years later, when prostatic symptoms had recurred and there was evidence of progressive nephropathy with dilatation of the upper urinary tract. Two patients died on admission and eight (47% of survivors) required long term dialysis, most patients (80%) requiring some dialysis support during the initial period. These findings suggest that progressive nephropathy caused by prostatic outflow obstruction might, in part, be averted by more adequate screening of renal function in men with untreated prostatism and closer follow up of patients with uraemia at the time of prostatectomy.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Abrams P. H., Roylance J., Feneley R. C. Excretion urography in the investigation of prostatism. Br J Urol. 1976;48(7):681–684. doi: 10.1111/j.1464-410x.1976.tb06719.x. [DOI] [PubMed] [Google Scholar]
  2. Ball A. J., Feneley R. C., Abrams P. H. The natural history of untreated "prostatism". Br J Urol. 1981 Dec;53(6):613–616. doi: 10.1111/j.1464-410x.1981.tb03273.x. [DOI] [PubMed] [Google Scholar]
  3. Craigen A. A., Hickling J. B., Saunders C. R., Carpenter R. G. Natural history of prostatic obstruction. A prospective survey. J R Coll Gen Pract. 1969 Oct;18(87):226–232. [PMC free article] [PubMed] [Google Scholar]
  4. Dunn B. R., Anderson S., Brenner B. M. The hemodynamic basis of progressive renal disease. Semin Nephrol. 1986 Jun;6(2):122–138. [PubMed] [Google Scholar]
  5. George N. J., Feneley R. C., Roberts J. B. Identification of the poor risk patient with "prostatism" and detrusor failure. Br J Urol. 1986 Jun;58(3):290–295. doi: 10.1111/j.1464-410x.1986.tb09057.x. [DOI] [PubMed] [Google Scholar]
  6. George N. J., O'Reilly P. H., Barnard R. J., Blacklock N. J. High pressure chronic retention. Br Med J (Clin Res Ed) 1983 Jun 4;286(6380):1780–1783. doi: 10.1136/bmj.286.6380.1780. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. George N. J., O'Reilly P. H., Barnard R. J., Blacklock N. J. Practical management of patients with dilated upper tracts and chronic retention of urine. Br J Urol. 1984 Feb;56(1):9–12. doi: 10.1111/j.1464-410x.1984.tb07154.x. [DOI] [PubMed] [Google Scholar]
  8. Jensen K. M., Jørgensen J. B., Mogensen P., Bille-Brahe N. E. Some clinical aspects of uroflowmetry in elderly males. A population survey. Scand J Urol Nephrol. 1986;20(2):93–99. doi: 10.3109/00365598609040555. [DOI] [PubMed] [Google Scholar]
  9. Jones D. A., George N. J., O'Reilly P. H., Barnard R. J. Reversible hypertension associated with unrecognised high pressure chronic retention of urine. Lancet. 1987 May 9;1(8541):1052–1054. doi: 10.1016/s0140-6736(87)90481-8. [DOI] [PubMed] [Google Scholar]
  10. O'Reilly P. H. Assessment before prostatectomy. Br Med J (Clin Res Ed) 1987 May 30;294(6584):1370–1371. doi: 10.1136/bmj.294.6584.1370-a. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. O'Reilly P. H., Brooman P. J., Farah N. B., Mason G. C. High pressure chronic retention. Incidence, aetiology and sinister implications. Br J Urol. 1986 Dec;58(6):644–646. doi: 10.1111/j.1464-410x.1986.tb05903.x. [DOI] [PubMed] [Google Scholar]
  12. Pinck B. D., Corrigan M. J., Jasper P. Pre-prostatectomy excretory urography: does it merit the expense? J Urol. 1980 Mar;123(3):390–391. doi: 10.1016/s0022-5347(17)55948-0. [DOI] [PubMed] [Google Scholar]
  13. Styles R. A., Ramsden P. D., Neal D. E. Chronic retention of urine. The relationship between upper tract dilatation and bladder pressure. Br J Urol. 1986 Dec;58(6):647–651. doi: 10.1111/j.1464-410x.1986.tb05904.x. [DOI] [PubMed] [Google Scholar]
  14. Warwick R. T., Whiteside C. G., Arnold E. P., Bates C. P., Worth P. H., Milroy E. G., Webster J. R., Weir J. A urodynamic view of prostatic obstruction and the results of prostatectomy. Br J Urol. 1973 Dec;45(6):631–645. doi: 10.1111/j.1464-410x.1973.tb12234.x. [DOI] [PubMed] [Google Scholar]
  15. Wood I. T., Mallick N. P., Wing A. J. Prediction of resources needed to achieve the national target for treatment of renal failure. Br Med J (Clin Res Ed) 1987 Jun 6;294(6585):1467–1470. doi: 10.1136/bmj.294.6585.1467. [DOI] [PMC free article] [PubMed] [Google Scholar]

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