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Nested case-control study
Inhaled anticholinergic medications in older men with chronic obstructive pulmonary disorder are associated with increased odds of acute urinary retention
  1. Robert Kyskan,
  2. Don D Sin
  1. Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
  1. Correspondence to Don D Sin
    Department of Medicine, University of British Columbia, St Pauls Hospital, 1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada; don.sin{at}

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Chronic obstructive pulmonary disease (COPD) affects 1 in 10 individuals more than 40 years of age.1 Many of these patients use inhaled anticholinergic (IAC) medications, often as a first-line therapy.2 Although IACs are generally poorly absorbed from the gastrointestinal and respiratory tracts, approximately 10–15% of the drug make it into the systemic circulation.3 Cholinergic receptors are expressed in prostatic tissue, and their stimulation may cause urinary retention.4 However, the risk of acute urinary retention (AUR) related to IAC use in the older COPD population is not known.


This was a population-based nested case-control study from Ontario, Canada, in which the risk of AUR was compared between …

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  • Competing interests DDS has received grants from Pfizer and Boehringer Ingelheim, makers of inhaled anticholinergics, as well as from AstraZeneca and GlaxoSmithKline, makers of long-acting β-2 agonists.