Incidence and predictors of transurethral resection of prostate in men with and without type 2 diabetes: the Fremantle Diabetes Study Phase I

BACKGROUND: The relationship between type 2 diabetes and the incidence of transurethral resection of the prostate (TURP) remains uncertain.

AIMS: To utilise data from the Fremantle Diabetes Study Phase I (FDS1) to examine the association between type 2 diabetes and incident TURP and investigate risk factors in men with type 2 diabetes.

METHODS: First TURP hospitalisations were ascertained for males from the Fremantle Diabetes Study Phase I (n = 581) and age- and postcode-matched men without diabetes (n = 2361) between entry (1993-1996) and end (2017). Incidence rate ratios (IRRs) were calculated. Cox proportional hazards and competing risk models generated cause-specific (cs) and subdistribution (sd) hazard ratios (HRs) for incident TURP.

RESULTS: There were 86 and 338 TURP hospitalisations in participants with and without type 2 diabetes, respectively, during 42 236 person-years of follow-up. The IRR (95% confidence interval) for diabetes versus no diabetes was 1.23 (0.96, 1.56). A 10-year age increase more than doubled the risk of incident TURP (csHR 2.51 (2.02, 3.12), sdHR 2.59 (2.11, 3.18)), but type 2 diabetes was not a significant predictor in multivariable models. In participants with type 2 diabetes, a 10-year age increase was predictive (csHR 2.94 (1.93, 4.47), sdHR 1.92 (1.51, 2.44)); Anglo-Celt versus other ethnic groups was significant in the Cox (csHR 1.87 (1.17, 3.00)) but not competing risk (sdHR 1.60 (0.99, 2.57)) models.

CONCLUSIONS: Type 2 diabetes does not increase TURP risk in community-based Australians. There are no diabetes-specific variables associated with incident TURP.