Determining the correlation between transition zone index with international prostate symptom score and peak flow rate on                      clinical outcome after transurethral resection of the prostate in benign prostatic hyperplasia

Background: Benign prostatic hyperplasia (BPH) is a pathologic process which has common contribution to lower urinary tract symptoms (LUTS) in aging men. International Prostate Symptom Score (IPSS) is an important means of assesment in the clinical research of LUTS and BPH. Free flow rates (peak flow rate or Qmax) give an indirect measure for the probability of obstruction whereas subvesical obstruction only can be measured by invasive pressure-flow studies. Among the various surgical or minimally invasive techniques available for BPH like Intraprostatic stents (temporary/permanent), transurethral needle ablation (TUNA), transurethral microwave thermotherapy (TUMT), transurethral electrovaporization of prostate (TUVP), Transurethral incision of prostate (TUIP), lasers (Nd: YAG (Neodymium-doped yttrium aluminium garnet), Ho: YAG (Holmium yttrium aluminium garnet), potassium titanyl phosphate (KTP), diode, thulium laser) etc, transurethral resection of the prostate (TURP) is a safe and effective procedure. Comparison of difference in the pre and postoperative ultrasonic prostatic volume with amount of tissue resected at operation has established the accuracy of the method. The aims of present study are to determine the correlation between transition zone index with international prostate symptom score (IPSS) and peak flow rate (Qmax) on clinical outcome after TURP in BPH patients.Methods: A prospective study was conducted to determine the effect of the extent of tissue resection on symptom improvement after TURP in men and to evaluate any potential correlation between prostate size and outcome.Results: Total of 52 patients studied prospectively. Transitional zone (TZ) index was found to have a significant correlation with the clinical outcome.Conclusions: Symptomatic improvement after TURP will depend on the amount of tissue resected in terms of IPSS and peak flow rates.

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Holmium Laser enucleation of the prostate (HoLEP) versus Transurethral Resection of the Prostate (TURP)

Revista do Colégio Brasileiro de Cirurgiões ◽

10.1590/0100-69912015003007 ◽

2015 ◽

Vol 42 (3) ◽

pp. 165-170 ◽

Cited By ~ 1

Author(s):

Luís Eduardo Durães Barboza ◽

Osvaldo Malafaia ◽

Luiz Edison Slongo ◽

Fernando Meyer ◽

Paulo Afonso Nunes Nassif ◽

...

Keyword(s):

Surgical Treatment ◽

Symptom Score ◽

Flow Rate ◽

Transurethral Resection ◽

International Prostate Symptom Score ◽

Peak Flow ◽

Prostatic Hyperplasia ◽

Peak Flow Rate ◽

Laser Enucleation ◽

Holmium Laser Enucleation

<sec><title>OBJECTIVE:</title>to evaluate the effectiveness and applicability of Holmium laser enucleation of the prostate (HoLEP) - in the treatment of benign prostatic hyperplasia (BPH) - in comparison to transurethral resection of the prostate (TURP).</sec><sec><title>METHODS:</title>patients with symptomatic prostatic hyperplasia and candidates for surgical treatment were selected. Both procedures were explained and they had choosen HoLEP or TURP. At the hospital were collected: age, date of birth, international prostate symptom score, urinary peak flow rate, prostate volume, post-voiding residual urine, globular volume and serum PSA. At the procedure operating time, morcellating time (HoLEP), bladder mucosal injury and intercurrences were collected. At the first postoperative day, globular volume and sodium. Besides that were observed the catheter indwelling time and hospital stay and after 90 days, urinary peak flow rate and international prostate symptom score. Statistical analisys have been done partially by Sinpe(r) and also by a professional team.</sec><sec><title>RESULTS:</title>twenty patients in HoLEP group and 21 at TURP were operated. Baseline urinary peak flow rate was 8 ml/s in both groups and preoperative international prostate symptom score was 22 in HoLEP and 20 in TURP, very similar. Operative time was 85 minutes in HoLEP and 60 in TURP, p<0.05. Hospital stay was 47 hours for HoLEP and 48 hours to TURP, p<0.05. At 90 day the urinary peak flow rate was raised to 21.5 ml/s in HoLEP group and to 20 ml/s in TURP and the median of international prostate symptom score had been reduced to score 3 in both groups.</sec><sec><title>CONCLUSION:</title>HoLEP is a feasible technique and is as effective as TURP on symptomatic prostatic hyperplasia surgical treatment.</sec>

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Clinical Significance of Intravesical Prostatic Protrusion in Patients with Benign Prostatic Hyperplasia

Journal of Universal College of Medical Sciences ◽

10.3126/jucms.v3i1.13248 ◽

2015 ◽

Vol 3 (1) ◽

pp. 6-10 ◽

Cited By ~ 3

Author(s):

Ghanshyam Sigdel ◽

WK Belokar

Keyword(s):

Benign Prostatic Hyperplasia ◽

Symptom Score ◽

Flow Rate ◽

International Prostate Symptom Score ◽

Prostate Volume ◽

Maximum Flow ◽

Prostatic Hyperplasia ◽

Medical Sciences ◽

Residual Urine ◽

Intravesical Prostatic Protrusion

INTRODUCTION: Intravesical prostatic protrusion is a morphological change due to excessive growth of the median and lateral lobes of the prostate into the bladder in benign prostatic hyperplasia. It causes a 'ball-valve' type of obstruction during voiding. It is a useful parameter to assess the severity of the disease process, selection of treatment modality and its possible outcome in benign prostatic hyperplasia.MATERIAL AND METHODS: A prospective, non-randomized, observational study was carried out from January 2014 to June 2014 in the Department of Urology, College of Medical Sciences, Nepal. Total of 50 patients with benign prostatic hyperplasia were evaluated to assess the correlation of intravesical prostatic protrusion with international prostate symptom score, prostate volume, maximum flow rate and post void residual urine. Correlation between parameters of interest was quantified with Pearson correlation test.RESULTS: A positive correlation was demonstrated between intravesical prostatic protrusion, international prostate symptom score, prostate volume and post void residual urine. There was a negative correlation between intravesical prostatic protrusion and maximum flow rate.CONCLUSION: Intravesical prostatic protrusion is correlated with international prostate symptom score, prostate volume, maximum flow rate, and post void residual urine volume and hence can be used to assess the severity of benign prostatic hyperplasia.Journal of Universal College of Medical Sciences Vol. 3, No. 1, 2015: 6-10

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Benign prostatic hyperplasia: Who will benefit from surgical intervention? A single center experience

Urologia Journal ◽

10.1177/03915603211019987 ◽

2021 ◽

pp. 039156032110199

Author(s):

Farzaneh Sharifiaghdas ◽

Mohammad Reza Khoiniha ◽

Abbas Basiri ◽

Milad Bonakdar Hashemi ◽

Nasrin Borumandnia ◽

...

Keyword(s):

Benign Prostatic Hyperplasia ◽

Medical Treatment ◽

Flow Rate ◽

Surgical Outcome ◽

Surgical Intervention ◽

Peak Flow ◽

Bladder Wall ◽

Prostatic Hyperplasia ◽

Peak Flow Rate

Background: To evaluate the pre-operative factors affecting clinical response to prostate surgery in men with benign prostatic hyperplasia (BPH). Materials and methods: In this prospective cohort study, 172 patients who underwent surgical intervention for BPH (either as open prostatectomy ( n = 78) or monopolar-trans-urethral resection of prostate ( n = 94) from February 2017 to October 2019 were consecutively enrolled. Pre-operative conventional three-lumen urodynamic study and transabdominal sonography were performed for all patients to determine peak flow rate (Qmax), detrusor pressure at the peak flow rate (PdetQmax), post-void residual volume (PVR), presence of detrusor overactivity (DO), prostate volume and median lobe size, and bladder wall thickness with empty and full bladder. Uroflowmetry and cystoscopy were performed during follow-up, whenever indicated. Successful surgical outcome was defined as subjective satisfaction of the patient and a Qmax of more than 15 ml/s on post-operative uroflowmetry. Results: At 1-year follow-up, complete resolution of lower urinary tract syndrome (LUTS) was detected in 138 (80.2%) patients; however, 21 (12.2%) still had pure obstructive LUTS, 9 (5.2%) had pure storage LUTS, and 4 (2.3%) were still suffering from both storage and obstructive LUTS. After performing multivariable analysis, shorter duration of pre-operative medical treatment and higher pre-operative bladder contractility index (BCI) were found to be independent predictors of successful surgery ( p = 0.012 and p < 0.001, respectively). Results of the ROC curve analysis showed that a preoperative BCI level more than 90.95 and pre-surgical medical treatment duration less than 14.45 months have the most specificity and sensitivity to predict the success of surgical outcome. We also observed that the probability of recovery decreased considerably over time following surgery. Conclusion: Shorter duration of pre-operative medical treatment and increased pre-operative BCI can independently predict favorable outcome of BPH surgery. These factors could be used for better patient management and appropriate planning and consultation before BPH surgery.

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