To investigate the association between COVID-19 infection and the 1-year risk of acute urinary retention (AUR) and related urological complications in patients with benign prostatic hyperplasia (BPH) and lower urinary tract symptoms (LUTs).
Using the TriNetX global network, patients with BPH and LUTs between January 2020 and January 2024 were identified. Participants were classified into a COVID-19 cohort (N = 32,948) and a non-COVID control cohort (N = 434,123). Propensity score matching (1:1) balanced demographics, comorbidities, medications, and laboratory parameters. The primary outcome was AUR within one year. Secondary outcomes included Foley catheterization, urinary tract infection (UTI), gross hematuria, bladder stones, and prostate-related surgery.
After matching, 32,918 patients remained in each cohort. The COVID-19 group showed a significantly higher 1-year incidence of AUR compared with controls (2.18% vs. 0.32%; aHR 6.89, 95% CI 5.62-8.45; p < 0.0001). Increased risks were also observed for Foley catheterization (aHR 4.10), UTI (aHR 3.52), and prostate-related surgery (aHR 6.02). Kaplan-Meier analysis demonstrated persistent divergence in AUR-free survival.
COVID-19 infection is independently associated with a markedly increased risk of AUR and urological complications in patients with BPH, highlighting the need for closer post-infection monitoring.
Life (Basel, Switzerland). 2026 Apr 25*** epublish ***
Jen-Chieh Lin, Cheng-Hua Lee, Jheng-Yan Wu, Wen-Hsin Tseng, Chien-Liang Liu, Steven K Huang, Allen W Chiu
Division of Urology, Department of Surgery, Chi Mei Medical Center, Tainan 71004, Taiwan., School of Medicine, College of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan., Department of Nutrition, Chi Mei Medical Center, Tainan 71004, Taiwan., Division of Uro-Oncology, Department of Surgery, Chi Mei Medical Center, Tainan 71004, Taiwan., Department of Urology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei 11008, Taiwan.