Prediction of Persistent Storage Symptoms after Transurethral Resection of the Prostate in Patients with Benign Prostatic Enlargement

Abstract

Objective: To identify the prognostic factors causing persistent storage symptoms following transurethral resection of the prostate in patients with benign prostatic enlargement (BPE). Methods: A total of 116 men with symptomatic BPE requiring surgery were enrolled in the study between January 2011 and December 2012. The patients underwent basic clinical evaluations including transrectal ultrasound, International Prostate Symptom Score and urodynamic study. After 6 months, International Prostate Symptom Score and uroflowmetry were rechecked. The definition of persistent storage symptoms was patients with storage scores >7 points. Logistic regression analysis and receiver operating characteristic analysis were conducted. Results: The 116 patients were divided into a persistent storage symptom-positive group (n = 33) and a storage symptom-negative group (n = 83). Multivariate analysis showed that the degrees of worse initial storage symptoms (odds ratio [OR] = 8.32), small bladder capacity (OR = 4.31), impaired detrusor contractility (OR = 2.96) and age (OR = 1.05) were consistently associated with persistent storage symptoms. Conclusions: This short-term study confirms the positive and consistent correlations between the baseline degree of worse initial storage symptoms, bladder capacity, detrusor contractility and age and the improvement in storage symptoms.

Outcome prediction of prostatic artery embolization: post hoc analysis of a randomized, open‐label, non‐inferiority trial

“…In contrast to a previous study , we found no correlation between patient age and reduction in symptoms after PAE. While in the TURP group in the trial, younger patients (<70 vs ≥70 years) had a more distinct improvement in IPSS, which is in line with previous studies on transurethral surgical techniques , this correlation was not found after PAE.…”

The relation between the storage symptoms before and after transurethral resection of the prostate, analysis of the risk factors and the prevention of the symptoms with solifenacin

“…In a retrospective study by Zhao et al involving 128 BPH patients, the outcomes of patients with mild preoperative SS were shown to be much better than those with moderate and severe symptoms (7). In Choi et al 's study with 116 patients, multivariate analysis has shown that poor initial SS were a risk factor for persistent SS in the postoperative period (OR=8.32) (10). In a study by Porru et al including 60 patients, postoperative symptom scores were shown to get worse in patients with significant preoperative SS (p=0.001) (11).…”

“…It is important for the surgeon and patients to know which group of patients is under risk for development of OABS after TURP. Several studies have shown that the success rates in the postoperative period were lower in patients with preoperative urodynamic detrusor overactivity (DO) and preoperative severe SS, although the data on this subject are contradictory (4)(5)(6)(7)(8)(9)(10)(11). So there is no consensus in this issue, which therefore needs further studies.…”

Clinical and Patient-reported Outcome Measures in Men Referred for Consideration of Surgery to Treat Lower Urinary Tract Symptoms: Baseline Results and Diagnostic Findings of the Urodynamics for Prostate Surgery Trial; Randomised Evaluation of Assessment Methods (UPSTREAM)

“…This reflects everyday reality of referral, but is a concern since outcomes of surgery to treat BOO are less reliable where storage LUTS are problematic [25]. In particular, nocturia was highly prevalent and bothersome (IPSS, ICIQ-MLUTS and bladder diary), yet nocturia often reflects systemic conditions unrelated to LUTS [9].…”