攝護腺肥大併急性尿滯留患者接受立即攝護腺刮除手術的預後
黃亮鋼1、邵翊紘1、李宗霖1、謝明里1、張英勛1、林友翔1、陳煜1、王敘涵1
林口長庚紀念醫院 外科部 泌尿科
Short-term prognosis of immediate transurethral surgery for benign prostate obstruction with acute urinary retention episode
Liang-Kang Huang1, I-Hung Shao1, Tsung-Lin Li1, Ming-Li Hsieh1, Ying-Hsu Chang1, Yu-Hsiang Lin1, Yu Chen1, Hsu-Han Wang1
Division of Urology, Department of Surgery; LinKou Chang Gung Memorial
Purpose: Transurethral surgery of prostate is nowadays the gold standard treatment modality for patients with benign prostatic hyperplasia (BPH) with recurrent acute urinary retention. This study aimed to evaluate the outcome and predictors of patients receiving immediate surgery after acute urinary retention (AUR) episodes.
Materials and Methods: From Jan 2016 to Jan 2017, we retrospectively included 714 patients received transurethral surgery of prostate due to BPH. Among them, 158 patients received surgeries immediately after AUR episode. General characteristics data including age, BMI, IPSS score, prostate volume, T-zone volume, and PSA were reviewed. We also collected surgery related parameters including surgical types, operation time, resection ratio and specimen weight. The catheterization status on discharge, post-operative α-blocker usage, and AUR within 3 months after operation were evaluated as 3 major end points. Statistical analysis was performed with SPSS.
Results: Mean age of overall patients were 73.5-year-old, with BMI 24.0 kg/m2. IPSS total score was 25.0 with V/S score 14.6 and 10.4 respectively. Prostate volume estimation under trans-urethral ultrasound showed total prostate volume 63.83(34.52) and T-zone volume 35.87(21.19). PSA before operation was 11.36(13.23). And resection ratio was 30.88(22.73). All patients were catheter-free after 1 month of surgery. Surgical type did not impact the outcome of surgeries. 14 patient (8.9%) experienced acute urine retention within 3 months after operation. In patients received transurethral surgery of prostate, resection ratio is the only predictor for the catheterization status on discharge and α-blocker usage 3 months after surgery.
Conclusions: Transurethral surgery of prostate provides favorable short-term outcomes in patients with AUR. More radical resection of prostate tissue during operation represents lower chance of catheterization on discharge and α-blocker usage after receiving surgery.