Metabolic syndrome and smoking are associated with persistence of nocturia after transurethral resection of the prostate

Neurourol Urodyn. 2019 Aug;38(6):1692-1699. doi: 10.1002/nau.24041. Epub 2019 May 20.

Abstract

Aims: The aim of our study was to evaluate the relationship between smoking, metabolic syndrome (MetS) and persistence of nocturia in patients with moderate/severe nocturia (nocturia episodes ≥2), lower urinary tract symptoms (LUTSs), and benign prostatic enlargement (BPE) undergoing transurethral resection of the prostate (TURP).

Methods: From 2015 onward, a consecutive series of patients with moderate/severe nocturia (nocturia episodes ≥2), LUTS, and BPE undergoing TURP were prospectively enrolled. Medical history, physical examination, and smoking status were recorded. MetS was defined according to Adult Treatment Panel III. Moderate/severe persistent nocturia after TURP was defined as nocturia episodes ≥2. Binary logistic regression analysis was used to evaluate the risk of persisting nocturia.

Results: One hundred two patients were enrolled with a median age of 70 years (interquartile range: 65/73). After TURP, moderate/severe nocturia was reported in 43 of 102 (42%) of the patients. Overall 40 of 102 (39%) patients presented a MetS, and out of them, 23 of 40 (58%) presented a moderate/severe persistent nocturia after TURP ( P = .001). Overall 62 of 102 (61%) patients were smokers, and out of them, 32 of 62 (52%) presented moderate/severe persistent nocturia after TURP ( P = .034). On multivariate analysis, prostate volume, MetS, and smoking were independent risk factors for moderate/severe persistent nocturia after TURP.

Conclusion: In our single-center study, MetS and smoking increased the risk of moderate/severe persistent nocturia after TURP in patients with LUTS-BPE. Although these results should be confirmed, and the pathophysiology is yet to be completely understood, counseling smokers and MetS patients about the risk of postoperative persistent nocturia is warranted.

Keywords: metabolic syndrome; nocturia; smoking.

MeSH terms

  • Aged
  • Humans
  • Lower Urinary Tract Symptoms / complications*
  • Lower Urinary Tract Symptoms / surgery
  • Male
  • Metabolic Syndrome / complications*
  • Middle Aged
  • Nocturia / etiology
  • Nocturia / surgery*
  • Prostatic Hyperplasia / complications*
  • Prostatic Hyperplasia / surgery
  • Risk Factors
  • Smoking*
  • Transurethral Resection of Prostate / adverse effects*