The correlation between clinical outcome and residual prostatic weight ratio after transurethral resection of the prostate for benign prostatic hyperplasia

Abstract

Objective To assess in a prospective study the use of a new variable, the residual prostatic weight ratio (RPWR), for evaluating the clinical outcome after transurethral resection of the prostate (TURP). Patients and methods From April 1996 to June 1997, 40 men (mean age 70.4 years, range 53± 85) with symptomatic benign prostatic hyperplasia were evaluated using the American Urological Association (AUA) symptom score, measurements of the mean and maximum urinary¯ow rate (Q ave and Q max ), and by transrectal ultrasonography (TRUS) before and 16 weeks after TURP. The estimated total prostate weight was derived as 0.52rlengthrwidthrheightrthe speci®c gravity of the prostate (1.010). The RPWR was calculated as the prostate weight after TURP divided by the initial weight, where the value after TURP was the initial weight minus that of the TURP specimen. The clinical outcome was evaluated by the difference (D)in AUA score, Q max and Q ave before and 16 weeks after surgery. Results There was a close correlation between the estimated prostate weight and the actual weight of the TURP specimen (r = 0.82 and 0.80 for the adenoma and total prostate, respectively). The mean (SD) RPWR, DAUA score, DQ max and DQ ave were 50.1 (17.1)%, 11.5 (5.3), 9.0 (4.2) mL/s and 6.2 (2.9) mL/s, respectively. There was a negative correlation between the RPWR and the DAUA, DQ max and DQ ave (r = x0.81, x0.68, and x0.70, respectively, P<0.05). The prostate volume estimated by TRUS decreased signi®cantly 16 weeks after TURP. Conclusions TRUS is a useful tool for estimating prostate weight before surgery. The smaller the RPWR at 16 weeks after TURP, the better the clinical outcome.

Transurethral resection of the prostate for the treatment of lower urinary tract symptoms related to benign prostatic hyperplasia: how much should be resected?

“…While some authors have suggested that better clinical results after TURP may correlate with the completeness of the resection of the obstructing adenoma (9,10), others have shown that partial resection produces short-term functional results comparable to those of standard TURP (11,12). The aim of this study was to evaluate the impact of the percent of resected tissue (PRT) during TURP on the short-term clinical outcome of patients with LUTS due to BPH.…”

Outcomes of Transurethral Resection of the Prostate in Benign Prostatic Hyperplasia Comparing Prostate Size of more than 80 Grams to Prostate Size less than 80 Grams

“…Some studies suggested complete resection should be performed for better result. 19,20 while others have suggested that a partial resection is adequate for short term functional results. 21,22 The recommended TURP technique consists of a complete resection of adenomatous tissue inside the surgical capsule for better result in terms of quality of life and symptom improvement.…”

Significance of operative parameters on outcomes after transurethral resection of the prostate

“…The majority of such studies did not pay attention to operative parameters such as the weight of residual tissue or RPWR, both of which indicate how complete an operation is. The importance of RPWR was firstly mentioned by Chen et al (9). These authors examined 40 men with symptomatic BPH and detected that the smaller the RPWR was at 16 weeks after TURP, the better was the clinical outcome.…”

“…Hakenberg et al analyzed the impact of residual prostatic weight (RPW) on outcomes after TURP and did not find a significant influence of this parameter on outcome (8). In their study, Chen et al detected a correlation between operative parameters and Qmax, International Prostate Symptoms Score (IPSS) and quality of life (QoL) (9) and concluded that better results were achieved when the residual prostate weight ratio (RPWR) was smaller. In the study presented herein, RPWR and RPW cutoff values that have a significant influence on an early outcome after TURP have been identified for the first time.…”