The association of statin subgroups with lower urinary tract symptoms following a prostate biopsy

Authors

  • Hanan Goldberg Urology Division, Surgical Oncology Department, Princess Margaret Cancer Centre, University Health Network, University of Toronto http://orcid.org/0000-0002-5777-2138
  • Faizan K. Mohsin
  • Thenappan Chandrasekar
  • Christopher J.D. Wallis
  • Zachary Klaassen
  • Ardalan E. Ahmad
  • Refik Saskin
  • Miran Kenk
  • Olli Saarela
  • Girish S. Kulkarni
  • Shabbir M.H. Alibhai
  • Neil Fleshner

DOI:

https://doi.org/10.5489/cuaj.7464

Keywords:

hydrophilic statins; Lower urinary tract symptoms; Prostate biopsy, Urinary retention

Abstract

Introduction: This was a secondary analysis aiming to assess whether hydrophilic or hydrophobic statins have a differential effect on urinary retention (UR) and lower urinary tract symptoms (LUTS) in men following a prostate biopsy (PBx), who were at risk for prostate cancer development.

Methods: This was a population-based cohort study with data incorporated from the Institute for Clinical and Evaluative Sciences database to identify all Ontarian men aged 66 and above with a history of a single negative PBx between 1994 and 2016, with no drug prescription history of any of several putative chemopreventative medications (statins, proton pump inhibitors, five alpha-reductase inhibitors, and alpha-blockers). Multivariable Cox regression models with time-dependent covariates were used to assess the association of hydrophilic and hydrophobic statins with UR and LUTS within 30 days of a PBx. All models were adjusted for other known putative chemopreventive medications, age, rurality, pharmacologically treated diabetes, comorbidity score, and study inclusion year.

Results: Overall, 21 512 men were included, with a median followup time of 9.4 years (interquartile range [IQR] 5.4–13.4 years). Hydrophobic and hydrophilic statins were initiated by 30.7% and 19.6% of men, respectively, after the first negative PBx. UR and LUTS were experienced by 2.2% and 10% of men, respectively. Cox models demonstrated hydrophilic statins were associated with a lower risk of UR (hazard ratio [HR] 0.56, 95% confidence interval [CI] 0.38–0.83, p=0.0038) and LUTS (HR 0.86, 95% CI 0.76–0.98, p=0.022), while no such association was shown for hydrophobic statins.

Conclusions: Initiation of hydrophilic statins in men older than 66 appears to be inversely associated with the risk of UR and LUTS within 30 days of a PBx.

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Author Biography

Hanan Goldberg, Urology Division, Surgical Oncology Department, Princess Margaret Cancer Centre, University Health Network, University of Toronto

Uro-oncology fellow (SUO), Princess Margaret Cancer Centre, University Health Network, University of Toronto

Published

2021-12-21

How to Cite

Goldberg, H., Mohsin, F. K. ., Chandrasekar, T. ., Wallis, C. J. ., Klaassen, Z. ., Ahmad, A. E. ., Saskin, R. ., Kenk, M. ., Saarela, O. ., Kulkarni, G. S. ., Alibhai, S. M. ., & Fleshner, N. . (2021). The association of statin subgroups with lower urinary tract symptoms following a prostate biopsy. Canadian Urological Association Journal, 16(5), E248–55. https://doi.org/10.5489/cuaj.7464

Issue

Section

Original Research