Complications and predictors of urinary retention among patients with prostatic obstruction at a tertiary hospital in northern Tanzania: a cross-sectional study

Background: Urinary retention (UR) is a common urological emergency among older men, most often caused by benign prostatic obstruction. In sub-Saharan Africa, delayed presentation and limited access to specialized urological care contribute to increased morbidity from UR and its complications. However, evidence on the spectrum of complications and predictors of UR among men with prostatic obstruction in Tanzania remains limited. This study aimed to describe the complications of UR and determine predictors of UR among patients with prostatic obstruction at a tertiary hospital in northern Tanzania. Methods: A hospital-based cross-sectional study was conducted in the urology department of Kilimanjaro Christian Medical Centre, Tanzania, from August 2024 to January 2025. Consecutive adult male patients with clinically and radiologically confirmed prostatic obstruction were enrolled. Data were collected using a structured questionnaire, physical examination, laboratory tests, and ultrasonography. UR was defined as the presence of an indwelling catheter or a post-void residual urine volume >300 mL. Complications assessed included urinary tract infection (UTI), hematuria, anemia, and renal impairment. Modified Poisson regression with robust standard errors was used to identify predictors of UR. Adjusted prevalence ratios (APRs) with 95% confidence intervals (CIs) were reported. Results: A total of 310 participants were included, with a mean age of 70 ± 9.3 years. Most participants had severe lower urinary tract symptoms (62.6%). UR was identified in 92 (29.7%) participants, of whom 78 (84.8%) had at least one complication. Renal impairment (64.1%) and UTI (50.0%) were the most common complications. In multivariable analysis, severe lower urinary tract symptoms (LUTS) (APR = 3.69; 95% CI: 1.19–11.45), suspicious malignant prostate features on digital rectal examination (APR = 3.56; 95% CI: 1.64–7.70), Grade 3 prostate enlargement (APR = 3.70; 95% CI: 1.22–11.25), elevated prostate-specific antigen (PSA) ≥10 ng/mL (APR = 1.76; 95% CI: 1.06–2.90), and residence in the Tanga region (APR = 3.61; 95% CI: 1.50–8.69) were independently associated with UR. Conclusion: UR and its complications are highly prevalent among men with prostatic obstruction in northern Tanzania, with renal impairment and UTI being the most common complications. Severe LUTS, advanced prostate enlargement, malignant prostate features, elevated PSA, and geographic disparities are independently associated with UR. Early risk stratification and timely intervention may reduce preventable morbidity in resource-limited settings.