Impact of COVID-19 Pandemic on Lower Urinary Tract Symptoms in Patients with Benign Prostatic Hyperplasia and Predictors of Urine Retention in Such Patients

Objectives We assess the effect of coronavirus disease 2019 (COVID-19) on lower urinary tract symptoms (LUTS) of patients with benign prostatic hyperplasia (BPH). Moreover, we delineate risk factors for urine retention in such patients. Methods All COVID-19 infected males were expeditiously evaluated. All enrolled patients were assessed using the International Prostate Symptom Score (IPSS), uroflowmetry, and pelvi-abdominal ultrasonography for prostate volume and postvoiding residual urine (PVR) estimation. Results Fifty patients, who were diagnosed with BPH, were enrolled. The mean age (+/- SD) was 62.64 +/- 7.69. In the pre- and post-COVID-19 group, the mean (+/- SD) IPSS was 13.42 +/- 4.32 and 26.62 +/- 5.77, respectively (P < .001), while PVR was 90.40 +/- 32.75 and 185.42 +/- 73.42, respectively (P < .001), and maximum flow rate was 14.40 +/- 2.75 and 10.74 +/- 3.43, respectively (P < .004). After infection with COVID-19, 13 (26%) patients were managed by urethral catheter fixation owing to urine retention. On bivariate analysis, age, diabetes, large prostate on digital rectal examination, alpha-blocker monotherapy, microscopic hematuria, positive urine culture, and pre-COVID-19 IPSS were significantly correlated with urine retention (P < .001, P = .01, P < .001, P = .06, P < .001, P = .04, and P < .001, respectively). On multivariate analysis, age, pre-COVID-19 IPSS, and positive urine culture were the independent predictors of urine retention (P = .05, P < .001, and P = .01, respectively). Conclusion LUTS in BPH patients were significantly affected by COVID-19. COVID-19 increases IPSS leading to a change in the treatment modality of BPH. On multivariate analysis, age, pre-COVID-19 IPSS, and positive urine culture were the independent predictors of urine retention post COVID-19 infection.