"CLAMP Score" to predict acute urinary retention in benign prostatic hyperplasia patients

In men older than 50 years, benign prostatic hyperplasia (BPH) is a common disease and progressive disease. Acute Urinary Retention (AUR) is one of the most common and painful long-term outcomes of BPH. Our study aimed at determining the risk factors which are responsible for developing AUR and formulating a novel scoring system known as "Retention Score" or "CLAMP Score" to predict the risk of developing AUR in BPH patients in future and manage them in advance.

The present study was a hospital-based comparative study which was conducted at the department of Urology, Nil Ratan Sircar Medical College and Hospital. Two groups were compared one "with AUR" and another "without AUR." Various risk factors have been studied including age, international prostate symptom score (IPSS), comorbidities like diabetes mellitus, serum PSA etc. From the study we have formulated and validated a simple out-patient based risk scoring known as "CLAMP Score" by which we can stratify the BPH patients into various risk groups of developing AUR.

A total of 240 patients has been divided into two groups; 120 in each group. It was found that, majority number of patients with AUR are more than 60 years of age (92.5%) and has comorbidities (84.0%). 68% of these patients has a serum PSA over 1.4 ng/dL and a history of AUR (75%). The mean IPSS was 26.8 and intravesical prostatic projection is more than 12 mm. Our proposed scoring system has a significant association with the patients with AUR group.

Our study provides valuable insights into the associations between various risk factors and AUR in BPH patients. Our proposed scoring system will be of great help in predicting AUR in BPH patients on out-patient basis and treat them accordingly in advance.