scholarly journals Elevated Tumor Necrosis Factor-α and Transforming Growth Factor-β in Prostatic Tissue are Risk Factors for Lower Urinary Tract Symptoms after Transurethral Resection of the Prostate in Benign Prostatic Hyperplasia Patients with Urinary Retention

2018 ◽  
Vol 11 (1) ◽  
pp. 46-53 ◽  
Author(s):  
Gede W.K. Duarsa ◽  
Anak A. G. Oka ◽  
Sri Maliawan ◽  
Doddy M. Soebadi ◽  
Putu Astawa ◽  
...  

Background: Lower Urinary Tract Symptoms (LUTS) after Transurethral Resection of the Prostate (TURP) occur in one-third of Benign Prostatic Hyperplasia (BPH) patients, may be caused by persistent prostatic inflammation and fibrosis. Objective: This study aims to evaluate the role of inflammation and fibrosis in pathological mechanism of LUTS among patients with BPH who underwent TURP by assessing their PSA, TNF-α, and TGF-β level. Design, Setting, and Participant: Data in this study were analyzed with the 2-way hypothesis. The study used odds ratio to define the risk factors of LUTS after TURP. The samples of the study are BPH patients after TURP aged 50-80 years old. Interventions: No intervention(s). Outcome Measurements and Statistical Analysis: The data analyzed using SPSS version 21.0 for Windows. Results and Limitations: There were 34 cases of LUTS and 42 controls without LUTS. We found that there were an increased levels of TNF-α (> 46.95 pg/ml) (OR 55.6, 95% Confidence Interval [CI] 11.1-278.4, p=0.00) and TGF-β (> 207.63 pg/ml) (OR 16.7, 95%CI 5.3-52.8, p=0.00). The result of multiple linear logistic regression analysis obtained equation Y= 0.033 x TNF-α + 0.031 x TGF-β. Population Attributable Risk (PAR) % TNF-α is 60%, PAR % TGF-β is 53%. Conclusion: Combination of elevated levels of TNF-α (>46.95 pg/ml) and TGF-β (>207.63) in prostate tissue is the risk factors for the occurrence of LUTS after TURP. Patient Summary: In this study, we enrolled 76 patients who were diagnosed with BPH and urinary retention. After TURP, there were 34 cases of LUTS and 42 controls without LUTS. We found that the levels of TNF-α and TGF-β between cases and controls were significantly different. We conclude that the combination of elevated levels of TNF-α and TGF-β in prostate tissue is the risk factors for the occurrence of LUTS after TURP.

2019 ◽  
Vol 9 (2) ◽  
pp. e18-e18
Author(s):  
Behzad Lotfi ◽  
Sajjad Farazhi ◽  
Mohammadreza Mohammadi Fallah ◽  
Mansour Alizadeh ◽  
Rohollah Valizadeh ◽  
...  

Introduction: Benign prostate hyperplasia, pathophysiology contributes to bladder outlet obstruction due to functional obstruction caused by gland size enlargement resulting in the lower urinary tract symptoms (LUTS). Objectives: To determine the correlation of the prostate volume with surgical outcomes and postoperative LUTS in patients with benign prostatic hyperplasia (BPH) undergoing transurethral resection of the prostate (TURP). Patients and Methods: Patients with BPH who were refractory for medical treatment enrolled in the study. Patients divided into three groups with attention to their prostate volume conducted by transabdominal ultrasonography. To evaluate patients’ LUTS, the International Prostate Symptom Score (IPSS) questionnaire was filled for all patients preoperatively and during the first and third months follow up sessions. Results: In the current study, mean age of the patients was 66.92 ± 1.08 years. Of 111 patients, eight patients (7.2%) had prostate volume less than 30 cc, 59 patients (53.2%) had prostate volume between 30-60 cc, and 44 patients (39.6%) had prostate volume more than 60 cc. During first month postoperative, mean decrease in IPSS scores in patients with prostate volume less than 30 cc, prostate volume between 30–60 cc and prostate volume more than 30 cc were 27.72 ± 3.53, 27.32 ± 3.37 and 27.45 ± 2.87, respectively. The ANOVA test showed no significant difference between the groups (P= 0.93). Mean decrease in IPSS score during third month postoperative, had no significant difference between the three groups, too (P=0.71). Symptoms alleviation observed in 94.6% and 95.5% of the patients, during first and third months follow-up, respectively. Conclusion: There was no correlation between the IPSS scores decrease and patients’ symptoms recovery and preoperative prostate volume in patients with BPH who underwent TRUP.


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