Change in storage symptoms after transurethral resection of prostate: a prospective observational study

Abstract

Introduction: Patients with enlarged prostate generally rate their storage symptoms (frequency, urgency and nocturia) as the most bothersome as these symptoms interfere more with daily activities and have huge impact on quality of life. Effect of transurethral resection of prostate (TURP) on storage symptoms is unknown. Objective of the study is to assess the change in storage symptoms in patients undergoing TURP.Methods: A prospective observational study was conducted at the author’s institute from August 2011 to July 2012. Patients undergoing TURP for moderate to severe lower urinary tract symptoms (LUTS) secondary to benign enlargement of prostate were included. Patients were evaluated by International prostate symptom score (IPSS) questionnaires. The question number 2, 4 and 7 of the IPSS questionnaire gave the storage symptom subscore (0-15). After initial evaluations, the patients underwent TURP. After 3 months, the IPSS was reevaluated and the change in storage symptom was analyzed.Results: A total of 57 patients who had undergone TURP were eligible for final data analysis. Majority of the patients had severe bothersome LUTS with mean IPSS score of 24.6±6. The baseline storage symptom subscore was 11.1±3. After 3 months of follow-up, there was significant decrease in total IPSS score and both of its subscores. On comparing the mean change in storage and voiding subscore, there was less decrement in storage subscore which was statistically significant (p=0.001). Conclusions: This study showed that after TURP change in voiding subscore occurs more than storage subscore and storage symptoms may not revert to normal.

Monopolar Transurethral Resection of Prostate for Benign Prostatic Hyperplasia in Patients With and Without Preoperative Urinary Catheterization: A Prospective Comparative Study

“…The mean preoperative IPSS and QOL scores in the non-catheterized group were 25.70 and 5.72, respectively, which was similar to the findings by Luitel et al but higher than reported by Choi et al [ 15 , 26 ]. The higher IPSS score may be due to the delayed presentation of our patients to seek care after the symptoms were significantly bothersome.…”

“…However, there was no significant difference with regard to complications higher than Clavien II. The improvement in complication rate in recent studies can be attributed to the advancements in surgical technique and technology related to the instrument's design [ 13 , 15 , 22 ].…”

“…Patients in our part of the world present late due to financial reasons, a misconception that it is the normal aging process, fear of surgery and need to travel a greater distance to seek a cure and thus need to have a catheter for a longer duration preoperatively [ 5 , 15 ]. This may be the reason for the significant number of patients having catheters for more than four weeks preoperatively.…”

“…In our part of the world, patients have preoperative Foley catheterization for a longer duration due to limited availability of urological care outside the major cities, financial constraints and even fear of surgery, in addition to the limited slots available for surgery in public hospitals [ 5 , 15 ]. There are limited studies addressing both the objective and subjective voiding outcomes of TURP among catheterized patients after failure of at least one trial without catheter (TWOC).…”

Sleep Quality Improvement of Benign Prostate Hyperplasia Patients After Transuretral Resection of Prostate

“…The mean values of some components increased significantly after TURP surgery, but no significant changes occurred in the symptoms of nocturia before and after surgery, with the conclusion that the ratio of improvement of nocturia to 7 symptoms of LUTS was the lowest 14 . Likewise, Luitel Gupat examined the results of post TURP surgery after 3 months showing a significant decrease in IPSS scores, symptoms of voiding that were better than storage symptoms but storage symptoms were unlikely to return to normal 15 . Naoki Wada's research in 2012 stated that nocturia is one of the most annoying symptoms of LUTS for patients and is the most difficult to treat because the disease that causes nocturia varies from urological conditions to non-urological conditions.…”