Factors Affecting the Improvement of the Initial Peak Urinary Flow Rate after Transurethral Resection of the Prostate or Photoselective Vaporization of the Prostate for Treating Benign Prostatic Hyperplasia
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Purpose: We evaluated the factors that affect the improvement of the initial peak flow rate after transurethral resection of the prostate (TURP) or photoselective vaporization of the prostate (PVP) for benign prostatic hyperplasia (BPH) patients by using noninvasive tools. Methods: One hundred and twenty seven BPH patients who had undergone TURP or PVP between January 2005 and May 2009 were evaluated. They were divided into 2 groups: the postoperative initial peak urinary flow rate (Qmax) was less than 10 mL/sec (Group 1; n=37, TURP=11, PVP=26) and more than 10 mL/sec (Group 2; n=90, TURP=41, PVP=49). We confirmed the patients’ preoperative check lists. The check list were the international prostate symptom score (IPSS), the quality of life score, a past history of acute urinary retention (AUR), body mass index and/or pyuria, the serum prostate-specific antigen (PSA) level and the prostate volume, the prostate transitional zone volume and prostatic calcification. The initial Qmax was measured at the outpatient clinic one week after discharge. Results: The improvement rate was not significant difference between the TURP group (78.8%) and the PVP group (65.3%). The efficacy parameters were the IPSS-storage symptom score, the prostate volume, the PSA level and a past history of AUR. The IPSS-storage symptom scores of Group 1 (12.3±3.3) was higher than those of Group 2 (10.5±1.7). The prostate volume of Group 2 (42.3±16.6 g) was bigger than that of Group 1 (36.6±7.8 g). The PSA level of Group 2 (3.8±2.6 ng/mL) was higher than that of Group 1 (2.6±2.6 ng/mL). A past history of AUR in Group 1 (35.1%) was more prevalent than that of Group 2 (15.6%). Conclusions: The non-invasive factors affecting the initial Qmax after TURP or PVP were the IPSS-storage symptom score, the prostate volume and a past history of AUR. Accordingly, in patients who have a higher IPSS-storage symptom score, a smaller prostate volume and a history of AUR, there might be a detrimental effect on the initial Qmax after TURP or PVP. These factors might also be used as long-term prognostic factors.
Abstract
Purpose: We evaluated the factors that affect the improvement of the initial peak flow rate after transurethral resection of the prostate (TURP) or photoselective vaporization of the prostate (PVP) for benign prostatic hyperplasia (BPH) patients by using noninvasive tools. Methods: One hundred and twenty seven BPH patients who had undergone TURP or PVP between January 2005 and May 2009 were evaluated. They were divided into 2 groups: the postoperative initial peak urinary flow rate (Qmax) was less than 10 mL/sec (Group 1; n=37, TURP=11, PVP=26) and more than 10 mL/sec (Group 2; n=90, TURP=41, PVP=49). We confirmed the patients’ preoperative check lists. The check list were the international prostate symptom score (IPSS), the quality of life score, a past history of acute urinary retention (AUR), body mass index and/or pyuria, the serum prostate-specific antigen (PSA) level and the prostate volume, the prostate transitional zone volume and prostatic calcification. The initial Qmax was measured at the outpatient clinic one week after discharge. Results: The improvement rate was not significant difference between the TURP group (78.8%) and the PVP group (65.3%). The efficacy parameters were the IPSS-storage symptom score, the prostate volume, the PSA level and a past history of AUR. The IPSS-storage symptom scores of Group 1 (12.3±3.3) was higher than those of Group 2 (10.5±1.7). The prostate volume of Group 2 (42.3±16.6 g) was bigger than that of Group 1 (36.6±7.8 g). The PSA level of Group 2 (3.8±2.6 ng/mL) was higher than that of Group 1 (2.6±2.6 ng/mL). A past history of AUR in Group 1 (35.1%) was more prevalent than that of Group 2 (15.6%). Conclusions: The non-invasive factors affecting the initial Qmax after TURP or PVP were the IPSS-storage symptom score, the prostate volume and a past history of AUR. Accordingly, in patients who have a higher IPSS-storage symptom score, a smaller prostate volume and a history of AUR, there might be a detrimental effect on the initial Qmax after TURP or PVP. These factors might also be used as long-term prognostic factors.
참고문헌 (18)
- Wasson JH, "A comparison of transurethral surgery with watchful waiting for moderate symptoms of benign prostatic hyperplasia. The Veterans Affairs Cooperative Study Group on Transurethral Resection of the Prostate", N Engl J Med, 332, pp.75~79 (1995)
- 박진성, "전립선비대증에서 광선택적 전립선기화와 경요도전립선절제술의 치료효과 비교", Korean Journal of Urology, 48(3), pp.297~303 (2007), 대한비뇨기과학회
- Bachmann A, "Photoselective vaporization (PVP) versus transurethral resection of the prostate (TURP): a prospective bi-centre study of perioperative morbidity and early functional outcome", Eur Urol, 48, pp.965~971 (2005)
- Barry MJ, "Watchful waiting vs immediate transurethral resection for symptomatic prostatism. The importance of patients’ preferences", JAMA, 259, pp.3010~3017 (1988)
- Jung PB, "Prognostic value of pressure-flow study and clinical parameters in the outcome measurement after transurethral prostatectomy in patients with BPH", Korean J Urol, 40, pp.1671~1676 (1999)
- 정윤석, "하부요로증상", 전립선비대증 환자에서 방광출구 폐색의 유무 및 방광 기능에 따른 경요도전립선절제술의 결과 및 만족도, 2007, pp.48(9), 965~970[DOI]
- Kim HH, "The effects and complications of transurethral resection for benign prostatic hyperplasia: results of long-term follow-up", Korean J Urol, 37, pp.268~280 (1996)
- Abrams PH, "The results of prostatectomy: a symptomatic and urodynamic analysis of 152 patients", J Urol, 121, pp.640~642 (1979)
- Fitzpatrick JM, "Minimally invasive and endoscopic management of benign prostatic hyperplasia. In: Wein AJ, Kavoussi LR, Novick AC, Partin AW, Peters CA, editors. Campbell-Walsh urology. 9th ed", pp.2831~2836 (2007), Philadelphia: Saunders
- Jensen KM, "Significance of prostatic weight in prostatism", Urol Int, 38, pp.173~178 (1983)
- Cockett AT, "Indications for treatment of benign prostatic hyperplasia. The American Urological Association Study", Cancer, 71(1 Suppl), pp.280~283 (1992)
- Hakenberg OW, "Preoperative urodynamic and symptom evaluation of patients undergoing transurethral prostatectomy: analysis of variables relevant for outcome", BJU Int, 91, pp.375~379 (2003)
- 임재균, "하부요로증상을 가진 남성 환자의 요역동학검사 소견 및 술 전 검사소견이 경요도전립선절제술의 결과에 미치는 영향", Korean Journal of Urology, 46(12), pp.1256~1261 (2005), 대한비뇨기과학회
- 장혁수, "전립선 이행대 용적: 전립선비대증 환자에서 급성요폐의 예견지표", Korean Journal of Urology, 46(3), pp.259~263 (2005), 대한비뇨기과학회
- Jang CS, "Post prostatectomy prognostic factors in patients with acute urinary retention due to benign prostatic hyperplasia", Korean J Urol, 45, pp.998~1001 (2004)
- 조진선, "전립선비대증 환자에서 혈청 전립선특이항원치와 전립선용적과의 상관관계: 다기관 연구", Korean Journal of Urology, 46(8), pp.792~798 (2005), 대한비뇨기과학회
- 김선국, "전립선비대증 환자에서 전립선내 석회화와 전립선내 림프구침윤이 경요도전립선절제술의 결과에 미치는 영향", Korean Journal of Urology, 44(1), pp.82~86 (2003), 대한비뇨기과학회
- Lee C, "The correlation between Transition Zone Index, versus IPSS and Peak Flow Rate after transurethral resection of prostate in benign prostatic hyperplasia", Korean J Urol, 40, pp.1318~1322 (1999)
