Benign prostat hiperplazisi nedeniyle transüretral prostat rezeksiyonu uygulanan hastalarda tedavi etkinliği ile ilişkili parametrelerin araştırılması

Year 2022, Volume: 61 Issue: 3, 452 - 459, 12.09.2022

Kasım Emre Ergün Serdar Kalemci Tuncer Bahçeci Fuat Kızılay Mehmet Ceyhun Özyurt

https://doi.org/10.19161/etd.1168246

Abstract

Amaç: Benign prostat büyümesi nedeniyle transüretral prostat rezeksiyonu yapılan hastalarda postoperatif yarar oranlarını ve postoperatif yararla ilişkili olabilecek çeşitli parametreleri değerlendirerek, transüretral prostat rezeksiyonunun tedavi etkinliğini değerlendirmeyi ve bunu öngörebilecek parametrelere ulaşılıp ulaşılamayacağını araştırmayı amaçladık.
Gereç ve Yöntem: 2015-2016 Temmuz tarihleri arasında kliniğimizde transüretral prostat rezeksiyonu yapılan 100 hasta retrospektif olarak değerlendirildi. Preoperatif tahmini prostat ağırlığı (TPA), uluslararası prostat semptom skoru (IPSS), maksimum akım hızı (Qmax) ve işeme sonrası rezidü idrar hacmi (PVR) değerleri ve rezeke edilen prostat dokusu ağırlıkları (RDA) kaydedildi. Postoperatif altı hafta ile altı ay arası dönemde hastaların verileri tekrar kaydedilip istatistiksel analizler yapıldı.
Bulgular: IPSS’deki azalmanın 11,40 (%53,4), Qmax’taki artışın 11,10 ml/sn (%110) ve PVR’deki azalmanın 59,60 ml (%59) olduğu tespit edildi. IPSS’deki düşüş, preoperatif IPSS ≥ 20 olanlarda, preoperatif Qmax ≤ 10 ml/sn olanlarda ve PVR >100 ml olanlarda istatistiksel anlamlı olarak daha fazla saptandı (sırasıyla p<0,001, p=0,038, p=0,012). Preoperatif PVR > 100 ml olan hastalarda Qmax’daki artış ve PVR’deki azalma istatistiksel anlamlı olarak daha fazla bulundu (sırasıyla p=0,012, p<0,001) TPA > 50 gr olan hastalarda ve RDA / TPA ≤ 0,3 olan hastalarda PVR azalması istatistiksel anlamlı olarak daha fazla bulundu (sırasyla p=0,027 ve p=0,008)
Sonuç: Transüretral prostat rezeksiyonu tedavi etkinliği ile ilişkili olabilecek daha net verilere ulaşılmasının hasta takibi ve tedavi seçimi konusunda klinisyenleri yönlendirebileceğini ve bu konuda daha fazla çalışma yapılması gerektiğini düşünmekteyiz.

Keywords

transüretral prostat rezeksiyonu, benign prostat hiperplazisi, alt üriner sistem semptomları

Investigation of parameters related to treatment efficiency in patients undergoing transurethral prostate resection for benign prostatic hyperplasia

Abstract

Aim : Evaluation of the postoperative benefit rates and various parameters that may be associated with the postoperative benefit in patients who underwent transurethral resection of the prostate due to benign prostate enlargement and the treatment efficacy of transurethral resection of the prostate and to investigate whether the parameters that can predict this can be achieved.
Materials and Methods: 100 patients who underwent transurethral resection of the prostate in our clinic between 2015-2016 July were evaluated retrospectively. Preoperative estimated prostate weight, international prostate symptom score , maximum flow rate, postvoid residual urine volume , and resected prostate tissue weights were recorded. In the postoperative six weeks to six months, the data of the patients were re-recorded and statistical analyzes were performed.

Results: It was determined that the decrease in IPSS was 11.40 (53.4%), the increase in Qmax was 11.10 ml/s (110%) and the decrease in PVR was 59.60 ml (59%). The decrease in IPSS was found to be statistically significantly higher in those with preoperative IPSS ≥ 20, preoperative Qmax ≤ 10 ml/sec, and PVR >100 ml (p<0.001, p=0.038, p=0.012, respectively). The increase in Qmax and decrease in PVR were found to be statistically significantly higher in patients with preoperative PVR >100 ml (p=0.012, p<0.001, respectively). PVR reduction was statistically significantly higher in patients with TPA > 50 g and RDA / TPA ≤ 0.3 (p=0.027 and p=0.008, respectively).
Conclusion: We think that obtaining clearer data that may be related to the efficacy of transurethral resection of the prostate can guide clinicians in patient follow-up and treatment selection, and more studies are needed on this subject.

Keywords

Transurethral Prostate Resection, benign prostate hyperplasia, lower urinary tract symptoms

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