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

Yıl 2018, , 131 - 135, 14.05.2018

Murat Zor

https://doi.org/10.5505/ptd.2017.24865

Öz

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

Anahtar Kelimeler

TURP, Alt üriner sistem semptomları (AÜSS), prostat boyutu, sistoskopi, sistometri

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

Öz

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

Anahtar Kelimeler

TURP, lower urinary tract symptoms, prostate volume, cystoscopy, cystometry

Kaynakça

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