A multicenter retrospective study of transurethral prostate split for benign prostate hyperplasia

Jingchao Wei; Shigeng Zhang; Bohan Wang; Mang Ke; Sheng Liu; Zhengjia Yang; Guoyun Zhou; Jiacheng Qian; Wenhui Lv; Yi Fan; Zhan Shi; Lijun Wan; Yongliang Chen; Jinkui He; Hui Liang; Huimin Long; Shijian Wang; Hao Wang; Bing Chen; Huan Shao; Binbin Yang; Chengfang Sun; Qi Huangfu; Chuanjun Du; Ming Cai; Jiaming Wen

doi:10.21037/tau-21-1138

A multicenter retrospective study of transurethral prostate split for benign prostate hyperplasia

Transl Androl Urol. 2022 Feb;11(2):213-227. doi: 10.21037/tau-21-1138.

Authors

Jingchao Wei¹, Shigeng Zhang¹, Bohan Wang¹, Mang Ke², Sheng Liu³, Zhengjia Yang⁴, Guoyun Zhou⁵, Jiacheng Qian⁶, Wenhui Lv⁷, Yi Fan⁸, Zhan Shi⁹, Lijun Wan¹⁰, Yongliang Chen¹¹, Jinkui He¹², Hui Liang¹³, Huimin Long¹⁴, Shijian Wang¹⁵, Hao Wang¹⁶, Bing Chen¹⁷, Huan Shao¹⁸, Binbin Yang¹⁹, Chengfang Sun¹, Qi Huangfu¹, Chuanjun Du¹, Ming Cai¹, Jiaming Wen¹

Affiliations

¹ Department of Urology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
² Department of Urology, Taizhou Hospital of Zhejiang Province, Taizhou, China.
³ Department of Urology, Taizhou Municipal Hospital, Taizhou, China.
⁴ Department of Urology, Linping District Chinese Hospital, Hangzhou, China.
⁵ Department of Urology, Lanxi Chinese Hospital, Jinhua, China.
⁶ Department of Urology, Cixi Third People's Hospital, Ningbo, China.
⁷ Department of Urology, Yongjia People's Hospital, Wenzhou, China.
⁸ Department of Urology, Zhejiang Xiaoshan Hospital, Hangzhou, China.
⁹ Department of Urology, Taizhou First People's Hospital, Taizhou, China.
¹⁰ Department of Urology, Quzhou People's Hospital, Quzhou, China.
¹¹ Department of Urology, Shaoxing Central Hospital, Shaoxing, China.
¹² Department of Urology, Yiwu Chinese Hospital, Jinhua, China.
¹³ Department of Urology, Xinchang County Hospital of Traditional Chinese Medicine, Shaoxing, China.
¹⁴ Department of Urology, Ningbo Medical Center Li Huili Hospital, Ningbo, China.
¹⁵ Department of Urology, Tongxiang First People's Hospital, Jiaxing, China.
¹⁶ Department of Urology, Naval Hospital of Eastern Theater, Zhoushan, China.
¹⁷ Department of Urology, Zhejiang Zhoushan Hospital, Zhoushan, China.
¹⁸ Department of Urology, Jiaxing Chinese Hospital, Jiaxing, China.
¹⁹ Department of Urology, Ningbo First Hospital, Ningbo, China.

Abstract

Background: Transurethral split of the prostate (TUSP) is effective in treating benign prostatic hyperplasia (BPH). However, there is still a lack of research focusing on the optimal target population for TUSP. This study aimed to compare the efficacy of TUSP in patients with different prostate volumes or ages.

Methods: The study was a multicenter retrospective study. The outcomes of TUSP in BPH patients with different prostate volumes or different ages were compared. A total of 439 patients were included in the study. Patients were divided into two groups according to prostate volume, with a cut-off value of 50 mL. Similarly, the cut-off value for the age groups was 70 years. Baseline patient characteristics and perioperative outcomes were recorded. Follow-up was performed at 1, 6, and 12 months after surgery.

Results: The mean age of the patients was 73.4 years, and the mean prostate volume was 51.2 mL. At 12-month follow-up after TUSP treatment, the patients' International Prostate Symptom Scores (IPSS), quality of life (QoL) scores, and postvoid residual (PVR) volumes decreased significantly, while peak urinary flow rate (Qmax) increased significantly. Intraoperative hemoglobin (Hb) reduction was significantly lower in the small volume group than in the large volume group. The incidence of postoperative urinary urgency and transient incontinence was lower in the small volume group. IPSS score, PVR, and Qmax in the small volume group showed more remarkable changes at several time points compared to the preoperative period. Postoperative pain scores were higher in the small volume group than in the large volume group. There were no differences between the two groups in terms of long-term complications. The younger group showed greater variation in PVR and Qmax at some time points but less variation in QoL than the older group.

Conclusions: TUSP is overall safe and effective in treating BPH. This study showed differences in the outcomes of TUSP in treating different prostate volumes or ages of BPH patients. The optimal surgical approach for BPH patients might be selected clinically based on a combination of prostate volume or patient age.

Keywords: Benign prostatic hyperplasia (BPH); age; prostate volume; transurethral split of the prostate (TUSP).