Analysis of benign prostatic obstruction surgery: A long-term evaluation in a real-life context
https://doi.org/10.4081/aiua.2022.3.295
Accepted: August 20, 2022
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Objective: Surgery is the treatment for male lower urinary tract symptoms (LUTS) relat-ed to benign prostatic obstruction (BPO) refractory to pharma-cological treatment or with complications. This study aimed to assess factors associated with the need for surgical reinterven-tion and/or continuation of pharmacological treatment.
Materials and methods: A retrospective analysis of patients who underwent prostatic surgery for male LUTS associated with BPO between 1 May 2015 and 1 May 2016, with a minimum follow-up of five years, in an academic tertiary hospital. The type of surgery, preoperative, postoperative and follow-up analysis were collected in a database.
Results: A total of 212 patients were included with a mean age of 70 ± 8.66 years at five years follow-up. At 5 years, a total of 86.9% of patients do not need pharmacological treatment and 12% required surgical reintervention. Of the preoperative parameters, it was found a relationship between prior prostatitis and the need for second surgery with an odds ratio of 4.6.
Conclusions: Patients should be informed of the potential need for pharmacological treatment following surgery, or even of the need for reintervention. History of prostatitis seems to be a risk factor for reintervention.
Kupelian V, Wei JT, O’Leary MP, et al. Prevalence of lower uri-nary tract symptoms and effect on quality of life in a racially and eth-nically diverse random sample: The Boston Area Community Health (BACH) survey. Arch Intern Med. 2006; 166:2381-7. DOI: https://doi.org/10.1001/archinte.166.21.2381
Gravas S, Cornu JN, Gacci M, et al. Management of non-neuro-genic male lower urinary tract symptoms (LUTS), incl. benign pro-static obstruction (BPO). Eur Assoc Urol Guidelines [Internet]. 2021; Available from: https://uroweb.org/wp-content/uploads/EAU-Guidelines-on-Non-Neurogenic-Male-LUTS-incl.-BPO-2020.pdf
Rassweiler J, Teber D, Kuntz R, Hofmann R. Complications of transurethral resection of the prostate (TURP)-Incidence, manage-ment, and prevention. Eur Urol. 2006; 50:969-80. DOI: https://doi.org/10.1016/j.eururo.2005.12.042
Reich O, Gratzke C, Bachmann A, et al. Morbidity, mortality and early outcome of transurethral resection of the prostate: a prospective multicenter evaluation of 10,654 Patients. J Urol. 2008; 180:246-9. DOI: https://doi.org/10.1016/j.juro.2008.03.058
Roehrborn CG. The utility of serum prostatic-specific antigen in the management of men with benign prostatic hyperplasia. Int J Impot Res. 2008; 20 (Suppl. 3): S19-26 DOI: https://doi.org/10.1038/ijir.2008.53
Bruskewitz R, Girman CJ, Fowler J, et al. Effect of finasteride on bother and other health-related quality of life aspects associated with benign prostatic hyperplasia. Urology. 1999; 54:670-8. DOI: https://doi.org/10.1016/S0090-4295(99)00209-5
Jacobsen SJ, Jacobson DJ, Girman CJ, et al. Treatment for benign prostatic hyperplasia among community dwelling men: The Olmsted County study of urinary symptoms and health status. J Urol. 1999;162:1301-6. DOI: https://doi.org/10.1016/S0022-5347(05)68271-7
Mebust WK, Holtgrewe HL, Cockett ATK, et al. Transurethral prostatectomy: Immediate and postoperative complications. Cooperative study of 13 participating institutions evaluating 3,885 patients. J Urol. 2002; 167:5-9. DOI: https://doi.org/10.1016/S0022-5347(05)65370-0
Mochtar CA, Kiemeney LALM, Van Riemsdijk MM, et al. Post-void residual urine volume is not a good predictor of the need for invasive therapy among patients with benign prostatic hyperplasia. J Urol. 2006; 175:213-6. DOI: https://doi.org/10.1016/S0022-5347(05)00038-8
Han HH, Ko WJ, Yoo TK, et al. Factors associated with continu-ing medical therapy after transurethral resection of prostate. Urology 2014; 84:675-80. DOI: https://doi.org/10.1016/j.urology.2014.04.027
Zhang L, Wang Y, Qin Z, et al. Correlation between prostatitis, benign prostatic hyperplasia and prostate cancer: A systematic review and meta-analysis. J Cancer. 2020; 11:177-89. DOI: https://doi.org/10.7150/jca.37235
Sauver JLS, Jacobson DJ, Mcgree ME, et al. Longitudinal Association between Prostatitis and Development of Benign Prostatic Hyperplasia. Urology. 2008; 71:475-9. DOI: https://doi.org/10.1016/j.urology.2007.11.155
Antunes AA, Srougi M, Coelho RF, et al. Transurethral resection of the prostate for the treatment of lower urinary tract symptoms related to benign prostatic hyperplasia: How much should be resect-ed? Int Braz J Urol. 2009; 35:683-9. DOI: https://doi.org/10.1590/S1677-55382009000600007
Park HK, Paick SH, Lho YS, et al. Effect of the ratio of resected tissue in comparison with the prostate transitional zone volume on voiding function improvement after transurethral resection of prostate. Urology. 2012; 79:202-6. DOI: https://doi.org/10.1016/j.urology.2011.07.1397
Melchior J, Valk WL, Foret JD, Mebust WK. Transurethral prostatectomy: computerized analysis of 2,223 consecutive cases. J Urol. 1974; 112:634-42. DOI: https://doi.org/10.1016/S0022-5347(17)59817-1
Hahn L, Leiter E. The effect of transurethral resection on the weight of resected tissue. J Urol. 1971;106:405-6. DOI: https://doi.org/10.1016/S0022-5347(17)61301-6
Rasmussen F. Weight loss of prostatic tissue during electroresec-tion. Scand J Urol Nephrol. 1975; 9:214-5. DOI: https://doi.org/10.3109/00365597509134214
Chen SS, Hong JG, Hsiao YJ, Chang LS. The correlation between clinical outcome and residual prostatic weight ratio after transurethral resection of the prostate for benign prostatic hyperpla-sia. BJU Int. 2000; 85:79-82. DOI: https://doi.org/10.1046/j.1464-410x.2000.00433.x
Lopes F, Pereira R, Fernandes M, et al. Prostate resection weight matters in severely obstructed men undergoing transurethral resec-tion of the prostate. Arch Ital Urol Androl. 2022; 94:169-73. DOI: https://doi.org/10.4081/aiua.2022.2.169
Sögütdelen E, Haberal HB, Guliyev F, Akdogan B. Urethral stric-ture is an unpleasant complication after prostate surgery: a critical review of current literature. J Urol Surg. 2016; 3:1-6. DOI: https://doi.org/10.4274/jus.773
Stucki P, Marini L, Mattei A, et al. Bipolar versus monopolar transurethral resection of the prostate: A prospective randomized trial focusing on bleeding complications. J Urol. 2015; 193:1371-6. DOI: https://doi.org/10.1016/j.juro.2014.08.137
Chen YZ, Lin WR, Chow YC, et al. Analysis of risk factors of bladder neck contracture following transurethral surgery of prostate. BMC Urol 2021;21:1-9. DOI: https://doi.org/10.1186/s12894-021-00831-6
Lee YH, Chiu AW, Huang JK. Comprehensive study of bladder neck contracture after transurethral resection of prostate. Urology. 2005; 65:498-503. DOI: https://doi.org/10.1016/j.urology.2004.10.082
Strope SA, Vetter J, Elliott S, et al. Use of medical therapy and success of laser surgery and transurethral resection of the prostate for benign prostatic hyperplasia. Urology. 2015; 86:1115-22.
Campbell RA, Gill BC. Medication discontinuation following transurethral prostatectomy: an unrecognized effectiveness measure?Curr Urol Rep. 2020; 21:61. DOI: https://doi.org/10.1007/s11934-020-01015-9
Campbell J, Reid J, Ordon M, Welk B. The utilization of benign prostatic hyperplasia and bladder-related medications after a transurethral prostatectomy. Urology 2019; 130:126-31. DOI: https://doi.org/10.1016/j.urology.2019.05.003
Pallauf M, Kunit T, Ramesmayer C, et al. Endoscopic enucleation of the prostate (EEP). The same but different—a systematic review. World J Urol. 2021; 39:2383-96. DOI: https://doi.org/10.1007/s00345-021-03705-6
Cho SY, Park J, Yoo S, et al. One-year surgical outcomes of com-plete or incomplete enucleation of prostate by monopolar electroco-agulation, photoselective vapoenucleation of 120-W GreenLight laser, and Holmium laser. Urology. 2017; 108:142-8. DOI: https://doi.org/10.1016/j.urology.2017.07.012
Kuntz RM, Lehrich K, Ahyai SA. Holmium laser enucleation of the prostate versus open prostatectomy for prostates greater than 100 grams: 5-year follow-up results of a randomised clinical trial. Eur Urol. 2008; 53:160-8. DOI: https://doi.org/10.1016/j.eururo.2007.08.036
Strope SA, Vetter J, Elliott S, et al. Use of medical therapy and success of laser surgery and transurethral resection of the prostate for benign prostatic hyperplasia. Urology. 2015; 86:1115-22. DOI: https://doi.org/10.1016/j.urology.2015.07.019
Mostafa MM, Patil N, Khalil M, et al. Is Holmium laser enucleation of prostate equally effective in management of benign prostatic hyper-plasia patients with either voiding or storage lower urinary tract symp-toms? A comparative study. Arch Ital Urol Androl. 2022; 94:174-9. DOI: https://doi.org/10.4081/aiua.2022.2.174
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.
Downloads
Citations
