The Factors Affecting on the Decision of the Surgical Treatment in Patients with Benign Prostatic Hyperplasia

PURPOSE: We set out to investigate which factors affect the decision for the surgical treatment on the patients with benign prostatic hyperplasia (BPH). MATERIALS AND METHODS: Between January 2000 and May 2006, a total of 505 newly diagnosed patients (group 1) and 219 preoperative patients (group 2) with symptomatic BPH were evaluated. International Prostate Symptom Score (IPSS), IPSS quality-of-life (QoL) assessment score, uroflow variables and prostate-specific antigen (PSA) were used for the assessment of the affecting factors of the operation in all groups. Other objective variables such as Schaefer's obstruction grade, detrusor pressure at maximal urinary flow and prostate volume were evaluated in preoperative patients. We analyzed the relationships between QoL score and other variables. RESULTS: With a result that the individual components of IPSS had influence on QoL, incomplete emptying, weak stream, nocturia, frequency, intermittency decreased QoL in group 1. In group 2, incomplete emptying, nocturia, frequency led to the decrease of QoL. Among them incomplete emptying had the strongest impact on symptom-specific QoL of both groups. In both groups objectively measurable variables for bladder outlet obstruction had a weak negative or no association with QoL in correlation analysis. CONCLUSION: The incomplete emptying was the most problematic for patients with BPH. If the BPH patients decide to undergo the surgical treatment, it can be predicted with the severity of the incomplete emptying.

Acute Urinary Retention due to Urethral Foreign Bodies

A 54-year-old man presented to the emergency department with a chief complaint of suprapubic pain and inability to void for 1 day after self insertion of urethral foreign bodies. These foreign bodies were two beans self inserted compulsively into the urethra by the patient. On physical examination, two materials of oval shape in the bulbous urethra were palpable. Retrograde urethrogram showed a complete obstruction in the bulbous urethra. When possible, endoscopic removal should be used for urethral foreign bodies. However the beans of our case required surgical retrieval. We present a case of foreign bodies in the urethra with brief review of literature. To our knowledge, this is the first case of acute urinary retention due to beans in Korean literature.