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J Clin Diagn Res. 2013 Dec;7(12):2859-62. doi: 10.7860/JCDR/2013/7606.3888. Epub 2013 Nov 18.

Outcome of surgery for benign prostatic hyperplasia-is it predictable?

Author information

  • 1Senior Resident, LHMC & SSKH , Formerly Junior Resident, UCMS & GTBH, Delhi, India .
  • 2Professor of Surgery & Surgical Unit Head, UCMS & GTBH , Delhi, India .
  • 3Professor, Department of Surgery & Surgical Unit Head , UCMS & GTBH , Delhi, India .
  • 4Assistant Professor, Department of Surgery, LHMC @ SSKH, New Delhi . Formerly lecturer, UCMS & GTBH , Delhi, India .
  • 5Formerly Senior Resident, UCMS & GTBH , Delhi, India .
  • 6Former Professor, Department of Surgery and Surgical Unit Head, UCMS & GTBH , Delhi, India .

Abstract

Aim: The study was done to evaluate the pre-operative and intra operative factors which influence the post-operative outcome in patients undergoing surgery for Benign Prostatic Hyperplasia (BPH). Setting and Design: It was carried out prospectively at a university college hospital in northern India. Material & Methods: The study was carried out prospectively in 31 patients who underwent surgery for BPH (TURP - 50, Open Prostatectomy - 10). Various pre-operative and intra-operative parameters were studied by means of a detailed history and examination, IPS score, urodynamic evaluation & cystoscopic examination. Their effect on post-operative outcome was evaluated by measuring changes in IPSS, maximum and average flow rates, and fall in PSA values. Statistical Analysis: Repeated measure ANNOVA was applied to calculate the significance of preoperative factors on post operative outcome (IPSS, Q max and Q av). Results: All parameters studied in the patients improved significantly following surgery. Patients who had pre-operative urinary retention and catheter at the time of surgery had significant improvement in both subjective (IPSS ,p=.oo4) and objective (maximum & average flow rates p=.04) parameters studied. Patients with larger prostrate had a significantly better maximum flow rate (p=.03) and IPSS at 3 months post-operatively. Similarly, patients with larger bladder capacity (more than 150 ml), better compliance (more than 6 ml per cm of water) and lower post-voidal residue (less than 60ml) had better post-operative outcome. Conclusion: Patients with pre-operative urinary retention, shorter duration of bladder catheterization, lower post voidal residue, high IPSS score, larger prostrate, larger bladder capacity and compliance had a significantly better outcome following surgery for BPH as assessed by various parameters studied.

KEYWORDS:

Benign Prostatic Hyperplasia; International prostate symptom score; Transurethral resection of prostate

PMID:
24551658
[PubMed]
PMCID:
PMC3919415
Free PMC Article
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