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Evaluation of the outcomes of TURP using Uroflowmetry data and IPSS in older patients with low prostate volume

Yıl 2025, Cilt: 15 Sayı: 5, 203 - 207
https://doi.org/10.16899/jcm.1737891

Öz

Background/Aims:
We aimed to evaluate the efficacy and safety of transurethral resection of prostate (TURP) without urodynamic testing in elderly patients with prostate volume less than 35 cc.
Methods:
A cohort of 116 patients over 70 years of age with a prostate volume less than 35 cc who underwent TURP were included in the study. International prostate symptom score (IPSS) and maximum flow rate (Qmax) measured by uroflowmetry were evaluated one month before the procedure and compared with the values at three and six months after the procedure. After exclusion of 24 patients with urethral stricture during TURP, the data set of 92 patients was subjected to further analysis.
Results:
The significant p value was p<0.05. The mean age of the patients was 74.4±4.2 years and the mean prostate volume was 31.4±3 cc. Qmax increased from 17.9 ± 4.3 ml/sec in the third postoperative month to 18.8 ± 4.6 ml/sec in the sixth month (p<0.001). IPSS decreased in the third and sixth postoperative months (15.9 ± 3 and 14.1 ± 3.2, respectively).
Conclusions:
A total of four (3.5%) patients had minor complications, all of which were managed conservatively. TURP is a safe and effective treatment option for elderly patients with low prostate volume without the need for urodynamic testing. We observed significant improvements in Qmax, PVR and IPSS scores.

Kaynakça

  • 1. Saitta G, Mantovani FA, Calabrese B, Aliboni C, Di Paola G, Meazza AL, et al. Prospective observational study on the efficacy and tolerability of a complex of phytochemicals versus dutasteride in the treatment of Lower Urinary Tract Symptomps due to Benign Prostatic Hyperplasia. Arch Ital Urol Androl. 2024;96(3):12869.
  • 2. Barry MJ, Fowler FJ, O’Leary MP, Bruskewitz RC, Holtgrewe HL, Mebust WK, et al. The American Urological Association symptom index for benign prostatic hyperplasia. The Measurement Committee of the American Urological Association. J Urol. 1992;148(5):1549-57.
  • 3. Rassweiler J, Schulze M, Stock C, Teber D, De La Rosette J. Bipolar transurethral resection of the prostate--technical modifications and early clinical experience. Minim Invasive Ther Allied Technol. 2007;16(1):11-21.
  • 4. Creta M, Russo GI, Bhojani N, Drake MJ, Gratzke C, Peyronnet B, et al. Bladder Outlet Obstruction Relief and Symptom Improvement Following Medical and Surgical Therapies for Lower Urinary Tract Symptoms Suggestive of Benign Prostatic Hyperplasia: A Systematic Review. Eur Urol. 2024;86(4):315-26.
  • 5. Baunacke M, Leuchtweis I, Kaufmann A, Schmidt M, Groeben C, Borkowetz A, et al. Decreasing Number of Urodynamics in Urological and Gynaecological Clinics Reflects Decreased Importance for Surgical Indications: German Population-Based Data from 2013 to 2019. Urol Int. 2022;106(10):1068-74.
  • 6. Wang JY, Liu M, Zhang YG, Zeng P, Ding Q, Huang J, et al. Relationship between lower urinary tract symptoms and objective measures of benign prostatic hyperplasia: a Chinese survey. Chin Med J (Engl). 2008 ;121(20):2042-5.
  • 7. Bosch JLHR, Bangma CH, Groeneveld FPMJ, Bohnen AM. The long-term relationship between a real change in prostate volume and a significant change in lower urinary tract symptom severity in population-based men: the Krimpen study. Eur Urol. 2008 ;53(4):819-27.
  • 8. Agrawal CS, Chalise PR, Bhandari BB. Correlation of prostate volume with international prostate symptom score and quality of life in men with benign prostatic hyperplasia. Nepal Med Coll J. 2008;10(2):104-7.
  • 9. Fowke JH, Phillips S, Koyama T, Byerly S, Concepcion R, Motley SS, et al. Association between physical activity, lower urinary tract symptoms (LUTS) and prostate volume. BJU Int. 2013;111(1):122.
  • 10. Kojima M, Hayakawa T, Saito T, Mitsuya H. [Age-related changes in lower urinary tract symptoms and urodynamic parameters in patients with benign prostatic hyperplasia treated by transurethral resection of the prostate]. Nihon Hinyokika Gakkai Zasshi. 2001;92(4):513-9.
  • 11. Li A, Lu H, Liu S, Zhang F, Qian X, Wang H. Effect of ageing on the efficacy efficiency of TUVRP. Aging Male. 2012;15(4):263-6.
  • 12. Ma J, Gharaee-Kermani M, Kunju L, Hollingsworth JM, Adler J, Arruda EM, et al. Prostatic fibrosis is associated with lower urinary tract symptoms. J Urol. 2012;188(4):1375-81.
  • 13. Lotterstätter M, Seklehner S, Wimpissinger F, Gombos J, Bektic J, Stolzlechner P, et al. Transurethral resection of the prostate in 85+ patients: a retrospective, multicentre study. World J Urol. 2022;40(12):3015-20.
  • 14. Wang L, Fan M, Ju W, Pang Z li, Zhu Z hui, Li B, et al. [Endourological treatment of aged high-risk patients with benign prostate hyperplasia: a report of 283 cases]. Zhonghua Nan Ke Xue. 2010;16(9):803-6.
  • 15. Jacobsen SJ, Jacobson DJ, Girman CJ, Roberts RO, Rhodes T, Guess HA, et al. Treatment for benign prostatic hyperplasia among community dwelling men: the Olmsted County study of urinary symptoms and health status. J Urol. 1999;162(4):1301-6.

Düşük prostat hacmi olan yaşlı hastalarda Üroflowmetri verileri ve IPSS kullanılarak TURP sonuçlarının değerlendirilmesi

Yıl 2025, Cilt: 15 Sayı: 5, 203 - 207
https://doi.org/10.16899/jcm.1737891

Öz

Amaç: Prostat hacmi 35 cc'nin altında olan yaşlı hastalarda ürodinamik test yapılmadan uygulanan Transüretral prostat rezeksiyonunun (TURP) etkinliğini ve güvenliğini değerlendirmeyi amaçladık.
Gereç ve Yöntemler: 70 yaş üstü, prostat hacmi 35 cc'nin altında olan ve TURP uygulanan 116 hastadan oluşan bir kohort grubu araştırmaya dahil edildi. İşlemden bir ay önce değerlendirilen Uluslararası prostat semptom skoru (IPSS) ve üroflowmetride ölçülen maksimum akış hızı (Qmax), işlem sonrası üç ve altı aylardaki değerlerle karşılaştırıldı. TURP sırasında üretral darlığı saptanan 24 hastanın çıkarılmasının ardından elde edilen 92 hastanın veri seti daha ileri analize tabi tutulmuştur.
Bulgular: Anlamlı p değeri p<0.05 idi. Hastaların ortalama yaşı 74.4 ± 4.2 yıl ve ortalama prostat hacmi 31.4±3 cc olarak hesaplandı. Qmax değeri ameliyat sonrası üçüncü ayda 17.9 ± 4.3 ml/sn iken altıncı ayda 18.8 ± 4.6 ml/sn'ye yükseldi (p<0.001). IPSS ameliyattan sonraki üçüncü ve altıncı aylarda azaldı (sırasıyla 15.9 ± 3, 14.1 ± 3.2).
Sonuç: Toplam dört (%3.5) hastada minör komplikasyon gözlendi ve bunların tümü konservatif yaklaşımla tedavi edildi. TURP, düşük prostat hacmine sahip yaşlı hastalar için ürodinamik teste ihtiyaç duymadan güvenli ve etkili bir tedavi seçeneğidir. Qmax, PVR ve IPSS skorlarında anlamlı iyileşmeler gözlemledik.

Kaynakça

  • 1. Saitta G, Mantovani FA, Calabrese B, Aliboni C, Di Paola G, Meazza AL, et al. Prospective observational study on the efficacy and tolerability of a complex of phytochemicals versus dutasteride in the treatment of Lower Urinary Tract Symptomps due to Benign Prostatic Hyperplasia. Arch Ital Urol Androl. 2024;96(3):12869.
  • 2. Barry MJ, Fowler FJ, O’Leary MP, Bruskewitz RC, Holtgrewe HL, Mebust WK, et al. The American Urological Association symptom index for benign prostatic hyperplasia. The Measurement Committee of the American Urological Association. J Urol. 1992;148(5):1549-57.
  • 3. Rassweiler J, Schulze M, Stock C, Teber D, De La Rosette J. Bipolar transurethral resection of the prostate--technical modifications and early clinical experience. Minim Invasive Ther Allied Technol. 2007;16(1):11-21.
  • 4. Creta M, Russo GI, Bhojani N, Drake MJ, Gratzke C, Peyronnet B, et al. Bladder Outlet Obstruction Relief and Symptom Improvement Following Medical and Surgical Therapies for Lower Urinary Tract Symptoms Suggestive of Benign Prostatic Hyperplasia: A Systematic Review. Eur Urol. 2024;86(4):315-26.
  • 5. Baunacke M, Leuchtweis I, Kaufmann A, Schmidt M, Groeben C, Borkowetz A, et al. Decreasing Number of Urodynamics in Urological and Gynaecological Clinics Reflects Decreased Importance for Surgical Indications: German Population-Based Data from 2013 to 2019. Urol Int. 2022;106(10):1068-74.
  • 6. Wang JY, Liu M, Zhang YG, Zeng P, Ding Q, Huang J, et al. Relationship between lower urinary tract symptoms and objective measures of benign prostatic hyperplasia: a Chinese survey. Chin Med J (Engl). 2008 ;121(20):2042-5.
  • 7. Bosch JLHR, Bangma CH, Groeneveld FPMJ, Bohnen AM. The long-term relationship between a real change in prostate volume and a significant change in lower urinary tract symptom severity in population-based men: the Krimpen study. Eur Urol. 2008 ;53(4):819-27.
  • 8. Agrawal CS, Chalise PR, Bhandari BB. Correlation of prostate volume with international prostate symptom score and quality of life in men with benign prostatic hyperplasia. Nepal Med Coll J. 2008;10(2):104-7.
  • 9. Fowke JH, Phillips S, Koyama T, Byerly S, Concepcion R, Motley SS, et al. Association between physical activity, lower urinary tract symptoms (LUTS) and prostate volume. BJU Int. 2013;111(1):122.
  • 10. Kojima M, Hayakawa T, Saito T, Mitsuya H. [Age-related changes in lower urinary tract symptoms and urodynamic parameters in patients with benign prostatic hyperplasia treated by transurethral resection of the prostate]. Nihon Hinyokika Gakkai Zasshi. 2001;92(4):513-9.
  • 11. Li A, Lu H, Liu S, Zhang F, Qian X, Wang H. Effect of ageing on the efficacy efficiency of TUVRP. Aging Male. 2012;15(4):263-6.
  • 12. Ma J, Gharaee-Kermani M, Kunju L, Hollingsworth JM, Adler J, Arruda EM, et al. Prostatic fibrosis is associated with lower urinary tract symptoms. J Urol. 2012;188(4):1375-81.
  • 13. Lotterstätter M, Seklehner S, Wimpissinger F, Gombos J, Bektic J, Stolzlechner P, et al. Transurethral resection of the prostate in 85+ patients: a retrospective, multicentre study. World J Urol. 2022;40(12):3015-20.
  • 14. Wang L, Fan M, Ju W, Pang Z li, Zhu Z hui, Li B, et al. [Endourological treatment of aged high-risk patients with benign prostate hyperplasia: a report of 283 cases]. Zhonghua Nan Ke Xue. 2010;16(9):803-6.
  • 15. Jacobsen SJ, Jacobson DJ, Girman CJ, Roberts RO, Rhodes T, Guess HA, et al. Treatment for benign prostatic hyperplasia among community dwelling men: the Olmsted County study of urinary symptoms and health status. J Urol. 1999;162(4):1301-6.
Toplam 15 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Üroloji
Bölüm Orjinal Araştırma
Yazarlar

Kürşad Dönmez 0000-0003-3581-3338

Serkan Özcan 0000-0002-2459-139X

Enis Mert Yorulmaz 0000-0003-2109-2015

Sacit Nuri Görgel 0000-0001-7628-1249

Osman Köse 0000-0003-4912-2597

Yiğit Akın 0000-0001-7627-3476

Yayımlanma Tarihi 27 Eylül 2025
Gönderilme Tarihi 15 Temmuz 2025
Kabul Tarihi 20 Ağustos 2025
Yayımlandığı Sayı Yıl 2025 Cilt: 15 Sayı: 5

Kaynak Göster

AMA Dönmez K, Özcan S, Yorulmaz EM, Görgel SN, Köse O, Akın Y. Evaluation of the outcomes of TURP using Uroflowmetry data and IPSS in older patients with low prostate volume. Journal of Contemporary Medicine. 15(5):203-207. doi:10.16899/jcm.1737891