Evaluation of quality of life after a transuretral resection of the prostate at the Pointe-a-pitre clinic

Abstract

Background: Trans-urethral resection of the prostate (TURP) remains to this day the "gold standard" for the treatment of obstructive prostatic hypertrophy and is both the surgical treatment of choice when the other methods fail. Its realization can affect the urinary and sexual functions, thus causing a repercussion on the quality of life of the patient. The absence of publications in our circles aroused the interest of this study. Aims: to assess the quality of life of patients who have benefited from an RTUP at the Pointe-à-Pitre Clinic. Methods: Through a cross-sectional approach carried out at Pointe-à-Pitre Clinic in Kinshasa during the period from June 2017 to June 2019, the data of the 65 patients who benefited from an RTUP had been collected and then analyzed. The assessment of quality of life was assessed using the IPSS score and the factors determining poor quality of life were sought by logistic regression with the calculation of the Odds ratio. The performance of the IPSS score was evaluated by the ROC curve with the determination of the area under the curve and the calculation of the Youden index. Results: A total of 65 patients aged on average 70.1 ± 6.3 years had benefited from a TURP, of which 90.8% were married and 81.5% were academics. Dysuria and nocturia were the main admission complaints in 72.3% and 26.2%. The ECBU showed Klebsiella Pneumoniae in 16.9% followed by E. Coli in 15.2% of cases. The pathological analysis had revealed prostatic carcinoma in 46% followed by HFLA associated with PIN 1-2 and chronic prostatitis in 28%. Post-operative complications were observed in 20% of cases including acute urinary retention (30.8%) and urinary incontinence (23.1%). Assessment of quality of life by the IPSS score showed that most patients had moderate (46.2%) to severe (21.5%) prostatic symptoms, with a considerable proportion of patients reporting an improvement in quality of life (78.5%) across the board versus only 20%, who reported poor quality of life. The factors associated with this poor quality of life were the occurrence of complications [OR: 8.2 95% CI (4.5-12.6), p <0.001] and moderate prostatic symptoms [OR: 3.5 95% CI (1.3-5.9), p = 0.002] to severe [OR: 7.5 95% CI (4.1-9.6), p = 0.001]. The ROC curve showed good performance predicting poor quality of life with an optimal score of 18, corresponding to a sensitivity of 88.0% and a specificity of 90.7% (Youden's index 0.607). Conclusion: RTUP currently occupies an important place in surgical urological activities in Kinshasa. It considerably improves the urinary function of patients as well as their general quality of life, but it can nevertheless have some repercussions including disorders of the lower urinary tract (acute urinary retention, urinary incontinence), hemorrhage, urinary tract infection and erectile dysfunction.

Bipolar Transurethral Resection of the Prostate (B-TURP) Including Large Prostate Glands in Kinshasa, DR Congo

“…Dysuria and acute urinary retention were the main symptoms, respectively in 46.1% and 23.03% (Figure 1). These results confirm those of some studies [15] [16] But different from some authors who report pollakiuria as being the main symptom in 90% of cases [17].…”