Comparative Analysis between Monopolar and Bipolar TURP - A Single Institute Prospective Controlled Study

Background: The ‘gold standard’ surgical treatment of clinically obstructive BPH is TURP, but life-threatening complications such as transurethral resection syndrome are occasionally observed. This has traditionally been provided as monopolar TURP, but morbidity associated with MTURP has led to the introduction of other surgical techniques. Objectives: To compare the effects of bipolar and monopolar TURP. Methods: In this prospective comparative study, 50 patients of each group undergo transurethral resection of prostate were enrolled and randomized to surgery by M‑TURP or B-TURP. International Prostate Symptom Score (IPSS), uroflowmetry, ultrasonography, prevoid, postvoid and international prostate symptom score (IPSS), maximum urinary flow rate (Qmax), postvoid residual urine (PVRU) volume, and prostate volume (PV). Complications and sequelae also assessed. Comparisons performed. Results:No significant differences found in baseline characteristics or operative data, No differences found in IPSS, Qmax or PVRU volume. Conclusions:Based on this controlled trial, there is not significant variation in effectiveness and safety between M-TURP and Bipolar -TURP for the treatment of BPH. Accordingly, M-TURP continues to be a valid option for the treatment of BPE. Keywords: Transurethral resection of prostate, Monopolar, Bipolar.

What Is the Interaction between Urine C-Reactive Protein, Prostatic Inflammation, and Doxazosin Treatment in Patients with Benign Prostatic Hyperplasia? A Pilot Study

<b><i>Introduction:</i></b> It was aimed to show the relationship between benign prostatic hyperplasia and inflammation by measuring urinary C-reactive protein values before and after alpha-blocker treatment. <b><i>Methods:</i></b> A total of 71 patients with a total prostate-specific antigen &#x3c;3.5 ng/mL, International Prostate Symptom Score &#x3e;7, and maximum urinary flow rate &#x3c;15 mL/s were included in the study. Doxazosin 4 mg p.o. once daily was started orally as an alpha-blocker treatment. Serum and urine C-reactive protein values, International Prostate Symptom Score, maximum urinary flow rate, and the post-void residual volume of patients were recorded at the first admission and in the first month of alpha-blocker treatment. <b><i>Results:</i></b> The mean age of the patients was 59.2 ± 7.5 years. The mean serum C-reactive protein values of the patients at the first admission and follow-up were 2.62 ± 1.8 (range, 0–5) mg/L and 2.83 ± 1.6 (0–6) mg/L, respectively. The mean urine C-reactive protein values of the patients at the first admission and follow-up were 0.45 ± 0.11 (range, 0.28–0.99) mg/L and 0.14 ± 0.04 (range, 0.79–0.328) mg/L, respectively, which was statistically significantly different. In the subgroup analysis, the urine C-reactive protein level change was more prominent in severely symptomatic patients than in moderately symptomatic patients. <b><i>Conclusion:</i></b> Our results showed that C-reactive protein was detectable in urine, alpha-blocker treatment significantly reduced urine C-reactive protein levels, and the decrease was more prominent in severely symptomatic patients.

Correlation of Intravesical Prostatic Protrusion in Benign Prostate Hyperplasia and Residual Lower Urinary Tract Symptoms After Surgery: A Systematic Review

Context: Intravesical prostatic protrusion (IPP) is a potential candidate for the initial evaluation of patients with lower urinary tract symptoms (LUTS). Intravesical prostatic protrusion is also known to predict the outcome of trials without a catheter and medical treatment outcomes and to determine bladder outlet obstructions. Objectives: This study aimed to determine whether IPP influences the residual LUTS after surgery in patients with benign prostate hyperplasia who have undergone prostate surgery. Evidence Acquisition: An online database search was conducted regarding the prognosis of postoperative benign prostate hyperplasia patients with intravesical prostatic protrusions. The selected databases comprised PubMed, ScienceDirect, EBSCO, and Cochrane Library. Randomized controlled trial, cohort, or case control studies that were written in English or Bahasa and published up until November 2020 were included. We reviewed postoperative outcomes, including subjective symptoms, based on the International Prostate Symptom Score and objective signs, such as Qmax and post voiding residue. Results: Our initial database search yielded 143 papers. After exclusion from abstract screening, seven papers were considered for full-text analysis. Five of these studies showed higher preoperative intravesical prostatic protrusion within successful postoperative outcomes. Some studies showed that patients with significant intravesical prostatic protrusions had more significant International Prostate Symptom Score decrements. However, two studies demonstrated that intravesical prostatic protrusion was not a significant prognostic factor. Conclusions: Most studies suggested that intravesical prostatic protrusion can predict better post-surgery lower urinary tract symptom outcomes. Further research using information about the risk of bias in ultrasound examination and more homogeneous surgical techniques and considering the duration of patients’ illness before they receive surgical management is needed.

Implementasi Metode International Prostate Symptom Score (IPSS) Untuk E-Screening Penentuan Gejala Benign Prostate Hyperplasia (BPH)

Benign Prostat Hyperplasia (BPH) merupakan pembesaran dari kelenjar prostat jinak yang umum dialami oleh pria lanjut usia yang memiki populasi sekitar 8% pada dekade ke 4 dan mengalami peningkatan hingga 90% dalam dekade ke 9. Pasien yang mengalami gangguan kesehatan perlu dilakukan pemeriksaan dini untuk segera mendapatkan kepastian penyakit dan segera mendapatkan pengobatan. Proses pemeriksaan untuk menentukan sejauh mana gejala yang dialami penderita menggunakan metode International Prostate Symptom Score (IPSS). Proses pemeriksaan tahap awal pasien masih dilakukan secara manual dengan melakukan tanya jawab antara dokter dengan pasien atau disebut dengan anamnesis. Anamnesis dilakukan untuk mendapatkan data tentang riwayat penyakit penderita yang pada umumnya dilakukan di rumah sakit atau puskesmas, hal tersebut berdampak kepada penderita yang merasa sensitif jika ditanyakan mengenai pertanyaan yang bersifat pribadi dan keterbatasan waktu dalam berfikir untuk menjawab pertanyaan-pertanyaan, oleh karena itu perlu dibangun sebuah sistem untuk memberikan solusi dari permasalahan tersebut berupa Sistem Informasi E-Screening untuk menentukan Gejala Benign Prostate Hyperplasia berbasis mobile yang dapat digunakan untuk masyarakat dalam melakukan pemeriksaan untuk mengetahui informasi penyakit yang diderita dan tingkat keparahan. Sistem yang dikembangkan telah dilakukan evaluasi menggunakan tabel confusion matrix. Hasil perhitungan diperoleh nilai accuracy 100%, nilai precision 100% dan nilai recall 100%

Effect of COVID 19 on Lower Urinary Track Symptoms in Patients With Benign Prostatic Hyperplasia

Background: Lower Urinary Track Symptoms (LUTS) in patients with BPH could be assessed by the International Prostate Symptom Score (IPSS). Studies find that COVID-19 can be detected in urine samples, although unreliably, this suggest the need to investigate whether the virus has effect on the urinary track especially those who are with pre-morbid conditions such as BPH. Hence the study aims to assess the effect of COVID-19 on the LUTS measured objectively by the IPSS on patients with BPH.Methods: 85 male patients over 40 years of age already diagnosed with BPH were included in the study. Any patient who recovered from a confirmed oropharyngeal swap PCR test was reassessed using I-PSS. Post-COVID19 IPSS surveys were compared to pre-COVID19 ones.Results: Out of 85 subjects, 39 (45.9%) were mild before COVID-19 compared to 19 (22.4%) after the infection. 46 subjects (54.1%) were moderate before COVID-19, whereas, 66 (77.6%) became moderate after the infection, (P < 0.001). The mean IPSS score of patients after they receive the appropriate treatment was found to be (8.1), while the mean score after COVID-19 infection was found to be (9.8). (P < 0.001) using paired sample t test.Conclusions: COVID-19 is associated with higher I-PSS score in patients with BPH, and more objective assessments are needed for further investigation.