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Transüretral Prostat Rezeksiyonu Sonrası Medikal Tedaviye Devam Durumunun Öngörülmesinde Preoperatif Prostat Boyutu Belirleyici midir?

Year 2018, Volume: 11 Issue: 2, 131 - 135, 14.05.2018
https://doi.org/10.5505/ptd.2017.24865

Abstract

GİRİŞ ve AMAÇ: Benign prostat hiperplazisi (BPH) nedeniyle TURP uygulanan
hastaların küçük de olsa bir bölümünde postoperatif alt üriner sistem
semptomları (AÜSS) devam etmekte ve bu hastalarda medikal tedaviye devam
edilmektedir. Biz de çalışmamızda, TURP uygulanan hastalarda prostat boyutu ile
postoperatif ek girişim oranları ve AÜSS nedeniyle medikal tedaviye devam
edilme oranları arasında ilişki olup olmadığını araştırdık.

YÖNTEM ve GEREÇLER: Preoperatif prostat boyutlarına göre hastalar Grup 1
(prostat hacmi ≥80 ml) ve Grup 2 (prostat hacmi <80 ml) olarak iki gruba
ayrıldı. Gruplar; preoperatif PSA değerleri ve prostat volümü, eşlik eden
ko-morbiditeler, postoperatif ek sistoskopi ve sistometri yapılıp yapılmadığı,
postoperatif medikal tedavi kullanımı açısından karşılaştırıldı.

BULGULAR: Çalışmaya toplam 87 hasta dahil edildi. Grup 1’deki 26 hastada
prostat boyutu ≥80 ml iken, grup 2’deki 61 hastada prostat boyutu <80 ml
idi. 87 hastanın 19’una (%22), postoperatif dönemde AÜSS’nin devam etmesi
nedeniyle, sistoskopi veya sistometri yapıldı ya da medikal tedavi yeniden
başlandı. İstatistiksel olarak anlamlı olmasa da, 80 ml altında prostat hacmi
olup, TURP uygulanan hastalarda, postoperatif AÜSS’nin daha sık görüldüğü
gözlendi.

TARTIŞMA ve SONUÇ: Her ne kadar TURP sonrası işeme bozukluklarını ve risk
faktörlerini belirlemek için prospektif ve geniş serili çalışmalara ihtiyaç
olsa da, elde ettiğimiz veriler büyük prostatlarda TURP’nin cerrahi
sonuçlarının daha yüz güldürücü olabileceğine işaret etmektedir.


Türkçe Kısa Başlık: Prostat Hacmi ve Tedaviye Devam Durumu

References

  • 1. Abrams P, Chpple C, Khoury S, Roehrborn C, de La Rosette J. International scientific committee. Evaluation and treatment of lower urinary tract symptoms in older men. J Urol 2009; 81: 1779-1787.
  • 2. S. Gravas, T. Bach, A. Bachmann, et al. EAU 2015 guidelines on the management of non-neurogenic male lower urinary tract tymptoms (LUTS), incl. Benign Prostatic Obstruction (BPO).
  • 3. Reich O, Gratzke C, Stief CG. Techniques and long-term results of surgical procedures for BPH. Eur Urol 2006;49(6):970-978.
  • 4. Joshi HN, De Jong IJ, Karmacharya RM, Shrestha B, Shrestha R. Outcomes of transurethral resection of the prostate in benign prostatic hyperplasia comparing prostate size of more than 80 grams to prostate size less than 80 grams. Kathmandu Univ Med J 2014;12(47):163-167.
  • 5. Han HH, Ko WJ, Yoo TK, et al. Factors associated with continuing medical therapy after transurethral resection of prostate. Urology 2014;84(3):675-680.
  • 6. Park HK, Paick SH, Lho YS, Jun KK, Kim HG. Effect of the ratio of resected tissue in comparison with the prostate transitional zone volume on voiding function improvement after transurethral resection of prostate. Urology 2012;79(1):202-206.
  • 7. Bruskewitz RC, Larsen EH, Madsen PO, Dørflinger T. 3-year follow up of urinary symptoms after transurethral resection of the prostate. J Urol 1986;136(3):613-615.
  • 8. Kakizaki H, Machino R, Koyanagi T. Clinical experience in lower urinary tract symptoms. BJU Int 2001;88:23-26.
  • 9. Thomas AW, Cannon A, Bartlett E, et al. The natural history of lower urinary tract dysfunction in men: minimum 10-year urodynamic followup of transurethral resection of prostate for bladder outlet obstruction. J Urol 2005;174:1887-1891.
  • 10. Hakenberg OW, Pinnock CB, Marshall VR. Preoperative urodynamic and symptom evaluation of patients undergoing transurethral prostatectomy: analysis of variables relevant for outcome. BJU Int. 2003;91(4):375-9.
  • 11. Seaman EK, Jacobs BZ, Blaivas JG, Kaplan SA. Persistence or recurrence of symptoms after transurethral resection of the prostate: a urodynamic assessment. J Urol. 1994;152(3):935-7.
  • 12. Lin YH, Hou CP, Chen TH, Juang HH, Chang PL, Yang PS, Lin YS, Chen CL, Tsui KH. Is diabetes mellitus associated with clinical outcomes in aging males treated with transurethral resection of prostate for bladder outlet obstruction: implications from Taiwan Nationwide Population-Based Cohort Study. Clin Interv Aging. 2017;12:535-541.
  • 13. Ransmayr GN1, Holliger S, Schletterer K, Heidler H, Deibl M, Poewe W, Madersbacher H, Kiss G. Lower urinary tract symptoms in dementia with Lewy bodies, Parkinson disease, and Alzheimer disease. Neurology. 200822;70(4):299-303.
  • 14. Ellenberg MAX. Development of urinary bladder dysfunction in diabetes mellitus. Ann Intern Med 1980;92:321-323.
  • 15. Yoshimura N, Chancellor MB, Andersson K, et al. Recent advances in understanding the biology of diabetes-associated bladder complications and novel therapy. BJU Int 2005;95:733-738.
  • 16. Kaplan SA. Re: Factors Associated with Continuing Medical Therapy after Transurethral Resection of Prostate. J Urol. 2015;194(2):482.
  • 17. Oelke M, Baard J, Wijkstra H, et al. Age and bladder outlet obstruction are independently associated with detrusor overactivity in patients with benign prostatic hyperplasia. Eur Urol. 2008;54:419-426

Does Preoperative Prostate Volume Predictive For Medical Therapy Continuation After Transurethral Prostate Resection?

Year 2018, Volume: 11 Issue: 2, 131 - 135, 14.05.2018
https://doi.org/10.5505/ptd.2017.24865

Abstract

INTRODUCTION: A small proportion of patients who underwent TURP for benign
prostate hyperplasia suffer from persistent lower urinary tract symptoms and
needs continuing medical treatment. In our study, we aimed to evaluate whether
or not is there any relationship between preoperative prostate volume and
postoperative persistent LUTS and medical treatment continuation.

METHODS: The patients were divided into two groups (group 1: prostate volume
≥80 ml, and group 2: prostate volume <80 ml) according to prostate volume.
Preoperative PSA levels, prostate volume, comorbidities, the necessity of
postoperative cystoscopy and cystometry and postoperative medical therapy
continuation were evaluated and compared between groups.

RESULTS: A total of 87 patients included to the study. Prostate volume was ≥80
ml in 26 patients (group1), and <80 ml in 61 patients (Group 2). Of 87
patients 19 (22%) had persistent LUTS and underwent cystoscopy, cystometry or
were restarted medical therapy. Despite there were no statistical significance,
LUTS were seen more frequently in patients who had prostate volume less than 80
ml.

DISCUSSION AND CONCLUSION: Despite high volume and prospective studies are
warranted for determining the risk factors for postoperative LUTS following
TURP operations, our study demonstrates that TURP operations may have better
outcomes in larger prostates.




İngilizce Kısa Başlık: Prostate Volume and Therapy Continuation

References

  • 1. Abrams P, Chpple C, Khoury S, Roehrborn C, de La Rosette J. International scientific committee. Evaluation and treatment of lower urinary tract symptoms in older men. J Urol 2009; 81: 1779-1787.
  • 2. S. Gravas, T. Bach, A. Bachmann, et al. EAU 2015 guidelines on the management of non-neurogenic male lower urinary tract tymptoms (LUTS), incl. Benign Prostatic Obstruction (BPO).
  • 3. Reich O, Gratzke C, Stief CG. Techniques and long-term results of surgical procedures for BPH. Eur Urol 2006;49(6):970-978.
  • 4. Joshi HN, De Jong IJ, Karmacharya RM, Shrestha B, Shrestha R. Outcomes of transurethral resection of the prostate in benign prostatic hyperplasia comparing prostate size of more than 80 grams to prostate size less than 80 grams. Kathmandu Univ Med J 2014;12(47):163-167.
  • 5. Han HH, Ko WJ, Yoo TK, et al. Factors associated with continuing medical therapy after transurethral resection of prostate. Urology 2014;84(3):675-680.
  • 6. Park HK, Paick SH, Lho YS, Jun KK, Kim HG. Effect of the ratio of resected tissue in comparison with the prostate transitional zone volume on voiding function improvement after transurethral resection of prostate. Urology 2012;79(1):202-206.
  • 7. Bruskewitz RC, Larsen EH, Madsen PO, Dørflinger T. 3-year follow up of urinary symptoms after transurethral resection of the prostate. J Urol 1986;136(3):613-615.
  • 8. Kakizaki H, Machino R, Koyanagi T. Clinical experience in lower urinary tract symptoms. BJU Int 2001;88:23-26.
  • 9. Thomas AW, Cannon A, Bartlett E, et al. The natural history of lower urinary tract dysfunction in men: minimum 10-year urodynamic followup of transurethral resection of prostate for bladder outlet obstruction. J Urol 2005;174:1887-1891.
  • 10. Hakenberg OW, Pinnock CB, Marshall VR. Preoperative urodynamic and symptom evaluation of patients undergoing transurethral prostatectomy: analysis of variables relevant for outcome. BJU Int. 2003;91(4):375-9.
  • 11. Seaman EK, Jacobs BZ, Blaivas JG, Kaplan SA. Persistence or recurrence of symptoms after transurethral resection of the prostate: a urodynamic assessment. J Urol. 1994;152(3):935-7.
  • 12. Lin YH, Hou CP, Chen TH, Juang HH, Chang PL, Yang PS, Lin YS, Chen CL, Tsui KH. Is diabetes mellitus associated with clinical outcomes in aging males treated with transurethral resection of prostate for bladder outlet obstruction: implications from Taiwan Nationwide Population-Based Cohort Study. Clin Interv Aging. 2017;12:535-541.
  • 13. Ransmayr GN1, Holliger S, Schletterer K, Heidler H, Deibl M, Poewe W, Madersbacher H, Kiss G. Lower urinary tract symptoms in dementia with Lewy bodies, Parkinson disease, and Alzheimer disease. Neurology. 200822;70(4):299-303.
  • 14. Ellenberg MAX. Development of urinary bladder dysfunction in diabetes mellitus. Ann Intern Med 1980;92:321-323.
  • 15. Yoshimura N, Chancellor MB, Andersson K, et al. Recent advances in understanding the biology of diabetes-associated bladder complications and novel therapy. BJU Int 2005;95:733-738.
  • 16. Kaplan SA. Re: Factors Associated with Continuing Medical Therapy after Transurethral Resection of Prostate. J Urol. 2015;194(2):482.
  • 17. Oelke M, Baard J, Wijkstra H, et al. Age and bladder outlet obstruction are independently associated with detrusor overactivity in patients with benign prostatic hyperplasia. Eur Urol. 2008;54:419-426
There are 17 citations in total.

Details

Primary Language Turkish
Subjects Clinical Sciences
Journal Section Research Article
Authors

Murat Zor

Publication Date May 14, 2018
Submission Date June 15, 2017
Acceptance Date December 8, 2017
Published in Issue Year 2018 Volume: 11 Issue: 2

Cite

AMA Zor M. Transüretral Prostat Rezeksiyonu Sonrası Medikal Tedaviye Devam Durumunun Öngörülmesinde Preoperatif Prostat Boyutu Belirleyici midir?. Pam Med J. May 2018;11(2):131-135. doi:10.5505/ptd.2017.24865

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