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 (PB), who were at risk for prostate cancer development.
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 PB 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 PB. All models were adjusted for other known putative chemopreventive medications, age, rurality, pharmacologically treated diabetes, comorbidity score, and study inclusion year.
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 PB. 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.
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 PB.
Canadian Urological Association journal = Journal de l'Association des urologues du Canada. 2021 Dec 21 [Epub ahead of print]
Hanan Goldberg, 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
Division of Urology, Department of Surgical Oncology, Princess Margaret Cancer Centre, University Health Network and the University of Toronto, Toronto, ON, Canada., Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada., Department of Urology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia PA, United States., Division of Urology, Department of Surgery, Medical College of Georgia, Augusta University, Augusta, GA, United States; Georgia Cancer Center, GA, United States., Institute for Clinical Evaluative Sciences, Toronto, ON, Canada., Department of Medicine, University Health Network and University of Toronto, Toronto, ON, Canada.