The clinical effect of TURP in patients with detrusor underactivity: a short-term follow-up / 中华泌尿外科杂志

ABSTRACT

Objective:To investigate the effect of transurethral prostatectomy (TURP) on patients with detrusor underactivity (DU).Methods:From January 2015 to January 2019, 72 male patients from Peking University People’s hospital who underwent TURP treatment were retrospectively analyzed. The age of all patients range from 51 to 89, with an average age of 72 years old. All patients underwent urodynamic examination before surgery. The patients were divided into three groups according to BCI and P detQmax. DU group(BCI<100 and P detQmax≤40 cmH 2O) consisted of 31 patients. Then DU patients were divided into two groups according to the P detQmax Group A, P detQmax≤20 cmH 2O, involving 9 patients; Group B, 20 cmH 2O<P detQmax≤40 cmH 2O, involving 22 patients. Non-DU group(BCI≥100 and 40 cmH 2O<P detQmax≤60 cmH 2O), also named the control GroupC, included 41 patients. There was no statistically significant difference in term of age and duration of disease among the three groups ( P<0.05). Preoperative international prostate symptom scores(IPSS)of the three groups were(26.40±5.54), (21.04±4.61)and(18.53±4.41), respectively. The quality of life score (QOL) were(4.70±1.34), (3.37±1.11)and(3.49±1.34), respectively. The Q max were(4.60±2.63), (8.48±2.47)and(11.38±4.00)ml/s, respectively. The residual urine volume (PVR) were(152.90±75.26), (90.78±51.97)and(53.23±38.98)ml, respectively. The preoperative IPSS and QOL of patients in group A were significantly higher than those in group B and group C, and the difference was statistically significant ( P<0.05), whereas the difference between group B and group C was not statistically significant ( P>0.05). The preoperative Q max of group A was significantly inferior than that of group B and C, with statistically significant difference ( P<0.05) and group B was significantly inferior than group C, with statistically significant difference ( P<0.05). The preoperative PVR of group A was significantly higher than that of group B and group C, with statistically significant difference ( P<0.05)and group B was significantly higher than group C, with statistically significant difference ( P<0.05). The above indicators were followed up to compare the improvement for the three groups of patients. Seventy-two patients were followed up for free Q max(fQ max) PVR, IPSS and QOL score from March 2019 to June 2019. Results:The 72 patients were followed up for 3 to 52 months, with an average of 31.1 months. Postoperative IPSS of the three groups were(25.50±2.84), (16.78±4.04)and(14.98±3.41), respectively. The QOL were (2.90±1.29), (2.67±0.88)and(2.53±0.92), respectively. The fQ max was (5.44±2.60), (10.30±3.68)and(13.07±3.51) ml/s, respectively, and PVR was(104.00±46.00), (76.81±46.74)and(35.64±26.17)ml, respectively. Compared with the preoperative parameters, QOL in group A was significantly improved, with statistically significant difference ( P<0.05) and the IPSS, fQ max and PVR in group A were improved, but the difference was not statistically significant ( P>0.05). The IPSS, QOL, fQ max and PVR in group B and C were significantly improved compared with the preoperative parameters, and the difference was statistically significant ( P<0.05). Conclusions:The subjective and objective indicators of DU patients can be improved after TURP, while for those patients whose P detQmax≤20 cmH 2O, only QOL can be improved significantly, and the other indicators can not be improved. Therefore, adequate communication should be made before surgery to inform reasonable expectations for the DU patients.