Objective: To evaluate preoperative comprehensive examinations of the IPSS-voiding to storage subscore ratio (IPSS-V/S), maximum urinary flow rate (Qmax), intravesical prostatic protrusion (IPP) and postvoid residual urine volume (PVR) in predicting the outcome of transurethral resection of the prostate (TURP) for BPH.
Methods: This retrospective study included 103 cases of BPH treated by TURP in Yixing People's Hospital from December 2018 to December 2019. The patients averaged 71.92 ± 7.73 years of age, with a mean prostate volume of (58.34 ± 15.59) ml, preoperative IPSS of 23.38 ± 3.36, voiding score of 14.38 ± 2.69, storage score of 9 (8－10), V/S ratio of 1.67 (1.43－1.88), Qmax of 7 (5－8) ml/s, IPP of 4 (0－5) mm, and PVR of (117.03 ± 20.51) ml. The TURP operations were completed by the same surgeon, with mean operation time of (83.65 ± 14.31) min and intraoperative blood loss of (55.32 ± 18.92) ml. The patients were followed up for 3 months after surgery for evaluation of the outcomes based on the IPSS and quality of life (QOL) scores.
Results: The postoperative IPSS was significantly improved in all the patients compared with the baseline (5.36 ± 1.95 vs 23.38 ± 3.36, P < 0.05). Based on the criteria of IPSS < 7 and general satisfaction with QOL, satisfactory results were achieved in 71 (68.93%) of the patients (aged 71.04 ± 7.23 years, prostate volume: ［59.68 ± 15.79］ ml, IPSS: 23.87 ± 3.42, voiding score: 14.87 ± 2.34, storage score: 9 ［8－10］, V/S ratio: 1.67 ［1.47－1.86］, Qmax: 6 ［4－7］ ml/s, IPP: 5 ［0－6］ mm, PVR: 110.53 ± 17.69 ml, operation time ［85.37 ± 12.28］ min, intraoperative blood loss: ［58.08 ± 14.61］ ml), and unsatisfactory results in the other 32 (31.07%) (aged 76.91 ± 8.25 years, prostate volume: ［55.38 ± 14.73］ ml, IPSS: 22.53 ± 3.25, voiding score: 13.53 ± 3.21, storage score: 9 ［8－12］, V/S ratio: 1.36 ［1.03－1.95］, Qmax: 8 ［7－9］ ml/s, IPP: 0 ［0－5］ mm, PVR: ［129.61 ± 20.62］ ml, operation time: ［78.85 ± 10.04］ min, intraoperative blood loss: 48.76 ± 12.19 ml).
Conclusions: TURP yields better results in younger BPH patients, with baseline IPSS dominantly in urinary symptoms, greater IPP, lower PVR, and lower Qmax.
Keywords: IPSS-voiding/storage subscores; effect prediction; intravesical prostatic protrusion; postvoid residual urine; ultrasonography; urodynamics; benign prostatic hyperplasia.