Is diabetes mellitus associated with clinical outcomes in aging males treated with transurethral resection of prostate for bladder outlet obstruction: implications from Taiwan Nationwide Population-Based Cohort Study
Yu-Hsiang Lin,1–3,* Chen-Pang Hou,1,2,* Tien-Hsing Chen,2,4 Horng-Heng Juang,5 Phei-Lang Chang,1,2 Pei-Shan Yang,1,2 Yu-Sheng Lin,2,6 Chien-Lun Chen,1,2 Ke-Hung Tsui1,2 1Department of Urology, Chang Gung Memorial Hospital – Linkou, 2School of Medicine, 3Graduate Institute of Cli...
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Dove Medical Press
2017
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oai:doaj.org-article:3c3718042cd64141ba2c3d3557c66b002021-12-02T02:08:00ZIs diabetes mellitus associated with clinical outcomes in aging males treated with transurethral resection of prostate for bladder outlet obstruction: implications from Taiwan Nationwide Population-Based Cohort Study1178-1998https://doaj.org/article/3c3718042cd64141ba2c3d3557c66b002017-03-01T00:00:00Zhttps://www.dovepress.com/is-diabetes-mellitus-associated-with-clinical-outcomes-in-aging-males--peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Yu-Hsiang Lin,1–3,* Chen-Pang Hou,1,2,* Tien-Hsing Chen,2,4 Horng-Heng Juang,5 Phei-Lang Chang,1,2 Pei-Shan Yang,1,2 Yu-Sheng Lin,2,6 Chien-Lun Chen,1,2 Ke-Hung Tsui1,2 1Department of Urology, Chang Gung Memorial Hospital – Linkou, 2School of Medicine, 3Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, 4Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital, Keelung, 5Department of Anatomy, School of Medicine, Chang Gung University, Kwei-shan, Tao-Yuan, 6Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan, Republic of China *These authors contributed equally to this work Purpose: We assessed the lower urinary tract symptoms (LUTSs) and clinical outcomes between diabetes mellitus (DM) patients and non-diabetic (non-DM) patients receiving transurethral resection of prostate (TUR-P). Methods: This analysis was a retrospective cohort study using 13 years (2000–2012) of claims data from Taiwan’s National Health Insurance Research Database (NHIRD). A total of 4,887 patients who had persistent LUTSs and underwent TUR-P for prostate enlargement (benign prostate enlargement [BPE]) were enrolled and divided into two groups: DM and non-DM groups. The patients’ characteristics, postoperative clinical outcomes, and the medication records after TUR-P were compared. Chi-square test was used for categorical variables and independent samples t-test for continuous variables. Multivariable logistic regression analysis was used to compare the risk of postoperative outcomes. Finally, we estimated the medication-free survival rate after TUR-P using Kaplan–Meier method and compared it between study groups using log-rank test. Results: DM group patients had a higher prevalence of comorbidities. Postoperatively, the DM group had lower rates of urinary tract infection (UTI; odds ratio [OR], 0.78; P=0.009) and higher rates of urinary retention requiring catheterization (OR, 1.35; P=0.01) within 1 month after TUR-P. A higher proportion of patients with DM took anti-muscarinics (OR, 1.23; P=0.032) within the first 3 months and α-blockers (OR, 1.18; P=0.049) during 3–12 months after receiving TUR-P. Overall, the DM group patients had a worse postoperative medication-free survival compared to that of non-DM group patients (95% confidence interval [95% CI], 1.14; P=0.005). Conclusion: DM patients require higher rates of continuing medication after TUR-P, especially anti-muscarinics in 3 months postoperatively and alpha-blocker after 3 months postoperatively. DM patients also had higher incidence of urine retention after surgery. DM patients had relatively poor treatment outcomes compared to DM-free patients. Keywords: benign prostate hyperplasia, infection, overactive bladder, prostatectomy, urinary tract infection, lower urinary tract symptomsLin YHHou CPChen THJuang HHChang PLYang PSLin YSChen CLTsui KHDove Medical PressarticleBenign prostate hyperplasiaDiabetes MellitusOveractive bladderProstatectomyUrinary tract infectionlower urinary tract symptomsGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 12, Pp 535-541 (2017) |
| institution |
DOAJ |
| collection |
DOAJ |
| language |
EN |
| topic |
Benign prostate hyperplasia Diabetes Mellitus Overactive bladder Prostatectomy Urinary tract infection lower urinary tract symptoms Geriatrics RC952-954.6 |
| spellingShingle |
Benign prostate hyperplasia Diabetes Mellitus Overactive bladder Prostatectomy Urinary tract infection lower urinary tract symptoms Geriatrics RC952-954.6 Lin YH Hou CP Chen TH Juang HH Chang PL Yang PS Lin YS Chen CL Tsui KH Is diabetes mellitus associated with clinical outcomes in aging males treated with transurethral resection of prostate for bladder outlet obstruction: implications from Taiwan Nationwide Population-Based Cohort Study |
| description |
Yu-Hsiang Lin,1–3,* Chen-Pang Hou,1,2,* Tien-Hsing Chen,2,4 Horng-Heng Juang,5 Phei-Lang Chang,1,2 Pei-Shan Yang,1,2 Yu-Sheng Lin,2,6 Chien-Lun Chen,1,2 Ke-Hung Tsui1,2 1Department of Urology, Chang Gung Memorial Hospital – Linkou, 2School of Medicine, 3Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, 4Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital, Keelung, 5Department of Anatomy, School of Medicine, Chang Gung University, Kwei-shan, Tao-Yuan, 6Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan, Republic of China *These authors contributed equally to this work Purpose: We assessed the lower urinary tract symptoms (LUTSs) and clinical outcomes between diabetes mellitus (DM) patients and non-diabetic (non-DM) patients receiving transurethral resection of prostate (TUR-P). Methods: This analysis was a retrospective cohort study using 13 years (2000–2012) of claims data from Taiwan’s National Health Insurance Research Database (NHIRD). A total of 4,887 patients who had persistent LUTSs and underwent TUR-P for prostate enlargement (benign prostate enlargement [BPE]) were enrolled and divided into two groups: DM and non-DM groups. The patients’ characteristics, postoperative clinical outcomes, and the medication records after TUR-P were compared. Chi-square test was used for categorical variables and independent samples t-test for continuous variables. Multivariable logistic regression analysis was used to compare the risk of postoperative outcomes. Finally, we estimated the medication-free survival rate after TUR-P using Kaplan–Meier method and compared it between study groups using log-rank test. Results: DM group patients had a higher prevalence of comorbidities. Postoperatively, the DM group had lower rates of urinary tract infection (UTI; odds ratio [OR], 0.78; P=0.009) and higher rates of urinary retention requiring catheterization (OR, 1.35; P=0.01) within 1 month after TUR-P. A higher proportion of patients with DM took anti-muscarinics (OR, 1.23; P=0.032) within the first 3 months and α-blockers (OR, 1.18; P=0.049) during 3–12 months after receiving TUR-P. Overall, the DM group patients had a worse postoperative medication-free survival compared to that of non-DM group patients (95% confidence interval [95% CI], 1.14; P=0.005). Conclusion: DM patients require higher rates of continuing medication after TUR-P, especially anti-muscarinics in 3 months postoperatively and alpha-blocker after 3 months postoperatively. DM patients also had higher incidence of urine retention after surgery. DM patients had relatively poor treatment outcomes compared to DM-free patients. Keywords: benign prostate hyperplasia, infection, overactive bladder, prostatectomy, urinary tract infection, lower urinary tract symptoms |
| format |
article |
| author |
Lin YH Hou CP Chen TH Juang HH Chang PL Yang PS Lin YS Chen CL Tsui KH |
| author_facet |
Lin YH Hou CP Chen TH Juang HH Chang PL Yang PS Lin YS Chen CL Tsui KH |
| author_sort |
Lin YH |
| title |
Is diabetes mellitus associated with clinical outcomes in aging males treated with transurethral resection of prostate for bladder outlet obstruction: implications from Taiwan Nationwide Population-Based Cohort Study |
| title_short |
Is diabetes mellitus associated with clinical outcomes in aging males treated with transurethral resection of prostate for bladder outlet obstruction: implications from Taiwan Nationwide Population-Based Cohort Study |
| title_full |
Is diabetes mellitus associated with clinical outcomes in aging males treated with transurethral resection of prostate for bladder outlet obstruction: implications from Taiwan Nationwide Population-Based Cohort Study |
| title_fullStr |
Is diabetes mellitus associated with clinical outcomes in aging males treated with transurethral resection of prostate for bladder outlet obstruction: implications from Taiwan Nationwide Population-Based Cohort Study |
| title_full_unstemmed |
Is diabetes mellitus associated with clinical outcomes in aging males treated with transurethral resection of prostate for bladder outlet obstruction: implications from Taiwan Nationwide Population-Based Cohort Study |
| title_sort |
is diabetes mellitus associated with clinical outcomes in aging males treated with transurethral resection of prostate for bladder outlet obstruction: implications from taiwan nationwide population-based cohort study |
| publisher |
Dove Medical Press |
| publishDate |
2017 |
| url |
https://doaj.org/article/3c3718042cd64141ba2c3d3557c66b00 |
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