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Evaluation of Storage Symptoms Improvement and Factors Affecting, After Relief of Obstruction in Patients With Benign Prostatic Enlargement

      Abstract

      Objectives

      To evaluate the improvement of storage symptoms in accordance with voiding symptoms and assess the prognostic factors that influence the relief of storage symptoms after transurethral resection of the prostate (TURP).

      Methods

      Between August 2017 and November 2019, 75 patients indicated for TURP were included in the study, we assessed the improvement of storage symptoms and factors that may influence storage symptoms persistence after TURP such as Age, Overactive bladder symptoms (OABS) score (Blaivas 2007) and Urodynamic parameters such as maximum flow rate (Q MAX), maximum cystometric capacity (MCC), bladder contractility index (BCI), phasic and terminal detrusor overactivity (DO). Assessment of patients was done before and 6 months after TURP by international prostate symptom score (IPSS), quality of life score (QLSS), OABSS (Blaivas score 2007), and urodynamic studies.

      Results

      Mean age of the patients was 67.88±7.82 years. The patients with persistence of storage symptoms were significantly older 70.43±8.32 vs 67.04±7.49 respectively P-value = 0.022, also IPSS score was significantly higher in patients with resolution of symptoms (26.83±3.91 vs 24.35±3.68 P = .017). Terminal D.O and Q max were significantly higher in patients with persistence of storage symptoms (26.3% and 8.1 vs 8.9% and 6 respectively). MCC was significantly higher in a patient with resolution vs persistence of storage symptoms (345.18±90.89 mL vs 242.16±72.73) respectively P = 0.001
      There was no significant difference between both groups regarding duration of symptoms, prostate size, prostatic specific antigen (PSA), QOL score, OABS score, and maximum detrusor pressure

      Conclusion

      more elderly patients with MCC less than 250 ccs and terminal DO were associated with worse outcomes and persistence of storage symptoms post TURP.
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      References

        • Wei JT
        • Calhoun E
        • Jacobsen SJ.
        Urologic diseases in America project: benign prostatic hyperplasia.
        J Urol. 2008; 179: S75-S80
        • Sarma AV
        • Wei JT.
        Clinical practice. Benign prostatic hyperplasia and lower urinary tract symptoms.
        N Engl J Med. 2012; 367: 248-257
        • Michel MC
        • Chapple CR
        Basic mechanisms of urgency: roles and benefits of pharmacotherapy.
        World J Urol. 2009; 27: 705-709
        • Oelke M
        • Baard J
        • Wijkstra H
        • de la Rosette JJ
        • Jonas U
        • Höfner K
        Age and bladder outlet obstruction are independently associated with detrusor overactivity in patients with benign prostatic hyperplasia.
        Eur Urol. 2008; 54: 419-426
        • Seki N
        • Takei M
        • Yamaguchi A
        • Naito S.
        Analysis of prognostic factors regarding the outcome after a transurethral resection for symptomatic benign prostatic enlargement.
        Neurourol. Urodyn. 2006; 25: 428-432
        • Gormley EA
        • Griffiths DJ
        • McCracken PN.
        • et al.
        Effect of transurethral resection of the prostate on detrusor instability and urge incontinence in elderly males.
        Neurourol Urodyn. 1993; 12: 445
        • Abrams PH
        • Farrar DJ
        • Turner-Warwick RT
        • et al.
        The results of prostatectomy: a symptomatic and urodynamic analysis of 152 patients.
        J Urol. 1979; 121: 640
        • Thomas AW
        • Cannon A
        • Bartlett E
        • Ellis-jones J
        • Abrams P.
        The long term urodynamic follow-up of turp.
        J Urol. 1999; 161: 257https://doi.org/10.1097/00005392-199904020-00030
        • Antunes AA
        • Iscaife A
        • Reis ST
        • et al.
        Can we predict which patients will experience resolution of detrusor overactivity after transurethral resection of the prostate?.
        J. Urol. 2015; 193: 2028-2032https://doi.org/10.1016/j.juro.2014.12.095
        • Choi H
        • Kim JH
        • Shim JS
        • et al.
        prediction of persistent storage symptoms after transurethral resection of the prostate in patients with benign prostatic enlargement.
        Urol Int. 2014; 93: 425-430
        • Losco G
        • Mark S
        • Jowitt S
        Transurethral prostate resection for urinary retention: does age affect outcome?.
        ANZ J Surg. 2013; 83: 243-245
        • Knutson T
        • Edlund C
        • Fall M
        • Dahlstrand C
        BPH with coexisting overactive bladder dysfunction– an everyday urological dilemma.
        Neurourol Urodyn. 2001; 20: 237-247
        • Han DH
        • Jeong YS
        • Choo MS
        • Lee KS.
        The efficacy of transurethral resection of the prostate in the patients with weak bladder contractility index.
        Urology. 2008; 71: 657-661
        • Thomas AW
        • Cannon A
        • Bartlett E
        • Ellis-Jones J
        • Abrams P
        The natural history of lower urinary tract dysfunction in men: minimum 10-year urodynamic follow up of transurethral resection of prostate for bladder outlet obstruction.
        J Urol. 2005; 174: 1887-1891
        • Seki N
        • Yuki K
        • Takei M
        • Yamaguchi A
        • Naito S
        Analysis of the prognostic factors for overactive bladder symptoms following surgical treatment in patients with benign prostatic obstruction.
        Neurourol Urodyn. 2009; 28: 197-201
        • Tanaka Y
        • Masumori N
        • Itoh N
        • Furuya S
        • Ogura H
        • Tsukamoto T
        Is the short-term outcome of transurethral resection of the prostate affected by preoperative degree of bladder outlet obstruction, status of detrusor contractility or detrusor overactivity?.
        Int J Urol. 2006; 13: 1398-1404
        • Zhao YR
        • Liu WZ
        • Guralnick M
        • et al.
        Predictors of short-term overactive bladder symptom improvement after transurethral resection of prostate in men with benign prostatic obstruction.
        Int J Urol. 2014; 21: 1035-1040
        • Kageyama S
        • Watanabe T
        • Kurita Y
        • Ushiyama T
        • Suzuki K
        • Fujita K
        Can persisting detrusor hyperreflexia be predicted after transurethral prostatectomy for benign prostatic hypertrophy?.
        Neurourol Urodyn. 2000; 19: 233-240