Acute urinary retention in men: 21‐year trends in incidence, subsequent benign prostatic hyperplasia‐related treatment and mortality: A Danish population‐based cohort study

OBJECTIVE: To examine trends in incidence of acute urinary retention, subsequent benign prostatic hyperplasia‐related treatment and mortality in the era of medical therapy for benign prostatic hyperplasia. Additionally, to compare mortality with the general population. MATERIALS AND METHODS: We conducted a Danish nationwide registry‐based study including 70,775 men aged 45 years or older with a first hospitalization for acute urinary retention during 1997–2017. We computed annual standardized incidence rates, subsequent 1‐year cumulative incidence of benign prostatic hyperplasia‐related surgical and medical treatment, and standardized 3‐month and 1‐year mortality rates. Finally, we compared standardized all‐cause and cause‐specific mortality ratios with the general population. RESULTS: The standardized incidence rate of acute urinary retention per 1000 person‐years increased transiently from 2.34 to 3.42 during 1997–2004, but gradually declined to 2.95 in 2017. The 1‐year cumulative incidence of benign prostatic hyperplasia‐related surgery declined from 31.2% to 19.8% and 20.5% to 7.7% after spontaneous and precipitated acute urinary retention, respectively. During 1997–2017, the standardized 1‐year mortality declined from 22.2% to 17.2%. Compared with the general population, mortality was 4–5 times higher after 3 months and 2–3 times higher after 1 year of acute urinary retention. The cause‐specific standardized mortality ratios were particularly high for deaths attributable to malignancies, urogenital disease, certain infections, chronic pulmonary disease, and diabetes. CONCLUSION: During 1997–2017, we observed a transient increase in the incidence of acute urinary retention. The subsequent use of benign prostatic hyperplasia‐related surgery declined considerably and mortality continued to be high, mainly because of deaths from malignancies, urogenital disease, infections, and preexisting comorbidity.