Clinical Outcome of Immediate Transurethral Surgery for Benign Prostate Obstruction Patients with Acute Urinary Retention: More Radical Resection Resulted in Better Voiding Function

Liang-Kang Huang; Ying-Hsu Chang; I-Hung Shao; Tsung-Lin Lee; Ming-Li Hsieh

doi:10.3390/jcm8091278

Clinical Outcome of Immediate Transurethral Surgery for Benign Prostate Obstruction Patients with Acute Urinary Retention: More Radical Resection Resulted in Better Voiding Function

J Clin Med. 2019 Aug 22;8(9):1278. doi: 10.3390/jcm8091278.

Authors

Liang-Kang Huang^{1

2}, Ying-Hsu Chang^{1

2}, I-Hung Shao^{1

2}, Tsung-Lin Lee^{1

2}, Ming-Li Hsieh^{3

4}

Affiliations

¹ Division of Urology, Department of Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan City 33302, Taiwan.
² College of Medicine, Chang Gung University, Taoyuan City 33302, Taiwan.
³ Division of Urology, Department of Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan City 33302, Taiwan. h0810@cgmh.org.tw.
⁴ College of Medicine, Chang Gung University, Taoyuan City 33302, Taiwan. h0810@cgmh.org.tw.

Abstract

Introduction: Transurethral surgery of the prostate is currently the gold standard treatment modality for patients with benign prostatic hyperplasia (BPH) with recurrent acute urinary retention. This study aimed to evaluate the outcome and predictors of patients receiving immediate surgery after acute urinary retention (AUR) episodes.

Materials and methods: From January 2016 to January 2017, we retrospectively included 714 patients who received transurethral surgery of prostate due to BPH. Among them, 158 patients received surgeries immediately after an AUR episode. General characteristics data including age, Body mass index (BMI), International prostate symptom score (IPSS score), prostate volume and Prostate-specific antigen (PSA) were reviewed. We also collected surgery-related parameters including surgical types, operation time, and specimen weight. Resection ratio was defined as (resected specimen weight)/(Transurethral ultrasound (TRUS) volume). The catheterization status on discharge, post-operative medication for BPH, and AUR within 3 months after operation were evaluated. Statistical analysis was performed with Statistical product and service solutions (SPSS).

Results: The mean age of the patients was 73.5 years, with a BMI of 24 kg/m². IPSS total score was 25 with a Voiding symptom/Storage symptom score (V/S score) of 14.6 and 10.4, respectively. A total of 74 (46.8%) patients still took medication for BPH for over 1 month after the surgeries, 28 (17.7%) patients were not catheter-free at the time of discharge, and 14 (8.9%) patients had AUR within 3 months after the surgeries. Surgical type did not impact the outcome of surgeries. In patients who received Transurethral resection of the prostate (TURP), the resection ratio is the only predictor for the catheterization status on discharge and post-operative medication for BPH within 3 months after operation.

Conclusions: In patients with BPH-related AUR followed by immediate transurethral surgeries, more radical resection is significantly correlated with short-term medication-free and catheter-free status.

Keywords: acute urinary retention; benign prostate obstruction; immediate surgery; laser vaporization; transurethral resection of prostate; transurethral surgery.