Prostate cancer (PCa) ranks sixth in cancer mortality among Taiwanese men, with smoking rates remaining high despite the 2009 Tobacco Hazards Prevention Act. This study used the Taiwan Cancer Registry to evaluate smoking’s impact on PCa mortality, providing important information for healthcare strategies and patient management. From 2011 to 2017, 23,107 PCa patients were analyzed, with 7164 smokers and 15,943 non-smokers. The baseline characteristics, clinical stages, comorbidities, and treatment modalities were all included to estimate overall and cancer-specific mortality using the Cox regression model and Kaplan–Meier analysis. The stratified analysis of clinical stage and age group was also estimated. Our study found an association between smoking and increased overall and cancer-specific mortality in PCa patients. Although smokers over 60 had higher risks of overall mortality than non-smokers, cancer-specific mortality did not show significant differences in any age group. Smokers had higher overall mortality than non-smokers across all clinical stages, but cancer-specific mortality was significantly raised only in early-stage cases. In conclusion, smoking is associated with higher overall mortality in PCa patients, with a significant increase in cancer-specific mortality in early-stage cases. Therefore, active smoking management is critical for clinical urologists, particularly in the treatment of early-stage patients.

Purpose: To investigate the association between COVID-19 infection and the 1-year risk of acute urinary retention (AUR) and related urological complications in patients with benign prostatic hyperplasia (BPH) and lower urinary tract symptoms (LUTs). Materials and Methods: Using the TriNetX global network, patients with BPH and LUTs between January 2020 and January 2024 were identified. Participants were classified into a COVID-19 cohort (N = 32,948) and a non-COVID control cohort (N = 434,123). Propensity score matching (1:1) balanced demographics, comorbidities, medications, and laboratory parameters. The primary outcome was AUR within one year. Secondary outcomes included Foley catheterization, urinary tract infection (UTI), gross hematuria, bladder stones, and prostate-related surgery. Results: After matching, 32,918 patients remained in each cohort. The COVID-19 group showed a significantly higher 1-year incidence of AUR compared with controls (2.18% vs. 0.32%; aHR 6.89, 95% CI 5.62–8.45; p < 0.0001). Increased risks were also observed for Foley catheterization (aHR 4.10), UTI (aHR 3.52), and prostate-related surgery (aHR 6.02). Kaplan–Meier analysis demonstrated persistent divergence in AUR-free survival. Conclusion: COVID-19 infection is independently associated with a markedly increased risk of AUR and urological complications in patients with BPH, highlighting the need for closer post-infection monitoring.