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The predictive factor for favorable outcome after surgical treatment for patients with urinary retention due to benign prostate hyperplasia - Is surgical modality important? |
| 순천향대학교 의과대학 비뇨기과학교실 |
| 김기홍, 김시현, 양희조, 김두상, 이창호, 전윤수 |
Introduction:
While it has been reported that holmium laser enucleation of the prostate (HoLEP) is an admirable challenger of transurethral resection of prostate (TURP), there is no comparative study about HoLEP and TURP which were performed for treatment of acute or recurrent urinary retention (UR) due to benign prostate hyperplasia (BPH). Therefore, we retrospectively evaluated outcomes after HoLEP or TURP, to compare with theses surgical modalities and to identify predictive factors for favorable outcomes after these surgical treatments which were performed for manage of UR.
Material and methods:
Of 220 patients who were treated with HoLEP or TURP, 48 (HoLEP) and 35 (TURP) patients who had the history of acute or recurrent UR were enrolled in this study. Preoperative and perioperative variables were evaluated to identify predictive factors for favorable outcome after surgical treatment which were performed for manage of UR..
Results :
TURP was significantly short operative time than HoLEP (70.0 min versus 112.5 min, median, p=0.002). However, other pre-, peri- and post-operative factors do not show significant differences. At 3 months postoperative after HoLEP or TURP, the median decrease in International Prostate Symptom Score (IPSS) was 17.0 (range: 10.0 – 23.0). Patients whose IPSS decreased by over 17 points were categorized into a favorable response group after HoLEP or TURP. Univariate and multivariate logistic regression analyses were performed to identify predictors of favorable outcomes at 3 months after HoLEP or TURP, and the preoperative IPSS was identified as an independent predictor for favorable outcomes (OR = 1.394, P<0.001).
Conclusions: When clinicians plan to perform surgical treatment in UR due to BPH, they should consider that the severity of symptoms is the most important factor for favorable outcomes. Both HoLEP and TURP are effective at improving urinary parameter in men with UR.
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keywords : benign prostatic hyperplasia, Holmium laser enucleation of the prostate, Transurethral resection of prostate |
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