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Jain A, Nassour AJ, Khannani H, Wines MP, Chalasani V, Katelaris P, Bergersen P, Symons JL, Baskaranathan S, Woo H. Australian surgical revision rate for benign prostatic obstruction. BJU Int 2023; 131 Suppl 4:43-47. [PMID: 37346012 DOI: 10.1111/bju.16031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/23/2023]
Abstract
OBJECTIVE To evaluate the rate of revision surgery following commonly performed procedures for benign prostatic hyperplasia (BPH) is hyperplasia of both glandular and stromal components of prostate especially in periurethral transitional gland, using real-world data from Medicare Australia. METHODS Prospection is a Healthcare Data Analytics firm that has negotiated access with the Medicare Benefits Schedule (MBS) to provide longitudinal data on the use of specific procedural item codes. We identified patients over the age of 40 years who had undergone primary transurethral resection of the prostate (TURP), transurethral incision of the prostate (TUIP) or photoselective vaporization of the prostate (PVP) between 2005 and 2010 using MBS item numbers 37203, 37207 and 36854, respectively. Using longitudinal MBS data, primary outcomes included need for revision surgery at 5-years follow-up (2015). The release of these data was approved by Medicare Australia upon application. Data analysis was conducted using chi-squared tests and statistical significance was defined at P < 0.05. RESULTS The distribution of primary surgical procedures performed between 2005 and 2010 was: TURP 5579 (90%), TUIP 345 (6%) and PVP 258 (4%). TURP was also the most prevalent procedure for treatment of lower urinary tract symptoms in men with BPH requiring revision surgery (75%). At 5-year follow-up the rate of revision surgery for TURP (573/5579), TUIP (47/345) and PVP (30/258) was 10.3%, 13.6% and 11.6%, respectively. The difference was not statistically significant (P = 0.12). There was no significant change (P = 0.59) observed over the years in number of men requiring revision surgery. CONCLUSION This study indicates that TURP and PVP have a similar durability after 5 years of follow-up.
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Affiliation(s)
- Anika Jain
- Department of Urology, Sydney Adventist Hospital, Wahroonga, NSW, Australia
- SAN Prostate Centre of Excellence, Sydney Adventist Hospital, Wahroonga, NSW, Australia
| | - Anthony-Joe Nassour
- Department of Urology, Sydney Adventist Hospital, Wahroonga, NSW, Australia
- SAN Prostate Centre of Excellence, Sydney Adventist Hospital, Wahroonga, NSW, Australia
| | - Hadia Khannani
- Department of Urology, Sydney Adventist Hospital, Wahroonga, NSW, Australia
- SAN Prostate Centre of Excellence, Sydney Adventist Hospital, Wahroonga, NSW, Australia
| | - Michael P Wines
- Department of Urology, Sydney Adventist Hospital, Wahroonga, NSW, Australia
- SAN Prostate Centre of Excellence, Sydney Adventist Hospital, Wahroonga, NSW, Australia
| | - Venu Chalasani
- Department of Urology, Sydney Adventist Hospital, Wahroonga, NSW, Australia
- SAN Prostate Centre of Excellence, Sydney Adventist Hospital, Wahroonga, NSW, Australia
| | - Phillip Katelaris
- Department of Urology, Sydney Adventist Hospital, Wahroonga, NSW, Australia
- SAN Prostate Centre of Excellence, Sydney Adventist Hospital, Wahroonga, NSW, Australia
| | - Philip Bergersen
- Department of Urology, Sydney Adventist Hospital, Wahroonga, NSW, Australia
- SAN Prostate Centre of Excellence, Sydney Adventist Hospital, Wahroonga, NSW, Australia
| | - James L Symons
- Department of Urology, Sydney Adventist Hospital, Wahroonga, NSW, Australia
- SAN Prostate Centre of Excellence, Sydney Adventist Hospital, Wahroonga, NSW, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- College of Health and Medicine, Australian National University, Canberra, ACT, Australia
| | - Sris Baskaranathan
- Department of Urology, Sydney Adventist Hospital, Wahroonga, NSW, Australia
- SAN Prostate Centre of Excellence, Sydney Adventist Hospital, Wahroonga, NSW, Australia
| | - Henry Woo
- Department of Urology, Sydney Adventist Hospital, Wahroonga, NSW, Australia
- SAN Prostate Centre of Excellence, Sydney Adventist Hospital, Wahroonga, NSW, Australia
- College of Health and Medicine, Australian National University, Canberra, ACT, Australia
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ERGÜN KE, KALEMCİ S, BAHÇECİ T, KIZILAY F, ÖZYURT MC. Investigation of parameters related to treatment efficiency in patients undergoing transurethral prostate resection for benign prostatic hyperplasia. EGE TIP DERGISI 2022. [DOI: 10.19161/etd.1168246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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 (p100 ml (p=0.012, p 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.
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Affiliation(s)
- Kasım Emre ERGÜN
- Ege Üniversitesi Tıp Fakültesi Üroloji Anabilim Dalı, İzmir, Türkiye
| | - Serdar KALEMCİ
- Ege Üniversitesi Tıp Fakültesi Üroloji Anabilim Dalı, İzmir, Türkiye
| | - Tuncer BAHÇECİ
- Ege Üniversitesi Tıp Fakültesi Üroloji Anabilim Dalı, İzmir, Türkiye
| | - Fuat KIZILAY
- Ege Üniversitesi Tıp Fakültesi Üroloji Anabilim Dalı, İzmir, Türkiye
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Lopes F, Pereira E Silva R, Fernandes M, Palmela Leitão T, Palma Dos Reis J. Prostate resection weight matters in severely obstructed men undergoing transurethral resection of the prostate. Arch Ital Urol Androl 2022; 94:169-173. [PMID: 35775341 DOI: 10.4081/aiua.2022.2.169] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 05/27/2022] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVES Transurethral resection of the prostate (TURP) remains one of the goldstandard surgical treatments for benign prostatic hyperplasia/lower urinary tract symptoms. The usefulness of a complete adenoma resection is questionable, with studies reporting no impact of the amount of resected tissue on surgical outcomes, irrespective of prostate volume. The aim of this study was to assess whether in less obstructed patients a less extensive TURP may be considered. MATERIALS AND METHODS Retrospective analysis of 185 men undergoing TURP in one university hospital. Retrieved data included pre-operative prostate volume and Qmax, as well as resected prostate weight and post-operative Qmax. Patients were divided in two groups according to pre-operative Qmax < 10mL/s and ≥ 10 mL/s. RESULTS A correlation was found between absolute resected prostate weight and post-operative Qmax in the group of patients with pre-operative Qmax < 10 mL/s (r2 = 0.038, p = 0.032), independently of the pre-operative prostate volume. This association was neither observed in the group of patients with pre-operative Qmax ≥ 10 mL/s (r2 = -0.033, p = 0.796) nor in whole population analysis (r2 = 0.019, p = 0.064). Likewise, in the group of patients with pre-operative Qmax < 10 mL/s, the improvement in Qmax was correlated with absolute resected weight and percentage of prostate resected weight (r2 = 0.036, p = 0.037 and r2 = 0.040, p = 0.029, respectively). None of these correlations was found in the group of patients with pre-operative Qmax ≥ 10 mL/s (r2 = 0.009, p = 0.463 and r2 = -0.018, p = 0.294, respectively). CONCLUSIONS Patients with pre-operative Qmax ≥ 10 mL/s may do well with less profound prostate resections, whereas patients with lower pre-operative Qmax seem to benefit from a complete adenoma resection.
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Affiliation(s)
- Filipe Lopes
- Urology Department, Centro Hospitalar Universitário Lisboa Norte, Lisbon.
| | - Ricardo Pereira E Silva
- Urology Department, Centro Hospitalar Universitário Lisboa Norte, Lisbon; Urology University Clinic, Faculty of Medicine, University of Lisbon.
| | - Miguel Fernandes
- Urology Department, Centro Hospitalar Universitário Lisboa Norte, Lisbon.
| | - Tito Palmela Leitão
- Urology Department, Centro Hospitalar Universitário Lisboa Norte, Lisbon; Urology University Clinic, Faculty of Medicine, University of Lisbon.
| | - José Palma Dos Reis
- Urology Department, Centro Hospitalar Universitário Lisboa Norte, Lisbon; Urology University Clinic, Faculty of Medicine, University of Lisbon.
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Liu H, Tian Y, Luo G, Su Z, Ban Y, Wang Z, Sun Z. Modified bladder outlet obstruction index for powerful efficacy prediction of transurethral resection of prostate with benign prostatic hyperplasia. BMC Urol 2021; 21:170. [PMID: 34872539 PMCID: PMC8650302 DOI: 10.1186/s12894-021-00937-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Accepted: 11/29/2021] [Indexed: 11/20/2022] Open
Abstract
Background The correlation between modified bladder outlet obstruction index (MBOOI) and surgical efficacy still remains unknown. The purpose of the study was to investigate the clinical value of the MBOOI and its use in predicting surgical efficacy in men receiving transurethral resection of the prostate (TURP).
Methods A total of 403 patients with benign prostate hyperplasia (BPH) were included in this study. The International Prostate Symptom Score (IPSS), quality of life (QoL) index, transrectal ultrasonography, and pressure flow study were conducted for all patients. The bladder outlet obstruction index (BOOI) (PdetQmax–2Qmax) and MBOOI (Pves–2Qmax) were calculated. All patients underwent TURP, and surgical efficacy was accessed by the improvements in IPSS, QoL, and Qmax 6 months after surgery. The association between surgical efficacy and baseline factors was statistically analyzed. Results A comparison of effective and ineffective groups based on the overall efficacy showed that significant differences were observed in PSA, Pves, PdetQmax, Pabd, BOOI, MBOOI, TZV, TZI, IPSS-t, IPSS-v, IPSS-s, Qmax, and PVR at baseline (p < 0.05). Binary logistic regression analysis suggested that MBOOI was the only baseline parameter correlated with the improvements in IPSS, QoL, Qmax, and the overall efficacy. Additionally, the ROC analysis further verified that MBOOI was more optimal than BOOI, TZV and TZI in predicting the surgical efficacy. Conclusion Although both MBOOI and BOOI can predict the clinical symptoms and surgical efficacy of BPH patients to a certain extent, however, compared to BOOI, MBOOI may be a more useful factor that can be used to predict the surgical efficacy of TURP. Trial registration retrospectively registered.
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Affiliation(s)
- Hongming Liu
- Department of Urology, The Affiliated Hospital of Guizhou Medical University, Guiyang, China
| | - Ye Tian
- Department of Urology, Guizhou Provincial People's Hospital, Guiyang, China.
| | - Guangheng Luo
- Department of Urology, Guizhou Provincial People's Hospital, Guiyang, China
| | - Zhiyong Su
- Department of Urology, The Affiliated Hospital of Guizhou Medical University, Guiyang, China
| | - Yong Ban
- Department of Urology, Guizhou Provincial People's Hospital, Guiyang, China
| | - Zhen Wang
- Department of Urology, Guizhou Provincial People's Hospital, Guiyang, China
| | - Zhaolin Sun
- Department of Urology, Guizhou Provincial People's Hospital, Guiyang, China
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Duarsa GWK, Dau DO, Pramana IBP, Tirtayasa PMW, Yudiana IW, Santosa KB, Oka AAG, Mahadewa TGB, Ryalino C. Risk Factors for Prostate Volume Progression After Prostate-Transurethral Resection. Res Rep Urol 2020; 12:175-178. [PMID: 32440513 PMCID: PMC7211307 DOI: 10.2147/rru.s249734] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 04/20/2020] [Indexed: 01/28/2023] Open
Abstract
Background Many factors could contribute to the cases of residual benign prostate hypertrophy (BPH) volume after transurethral resection of the prostate (TURP), such as age, obesity, testosterone level, and inflammation. The goal of this study was to determine the risk of tumor necrosis factor-α (TNF-α), transforming growth factor-β (TGF-β) in prostate tissue, serum prostate-specific antigen (PSA), serum testosterone, and age in promoting prostate volume progression after TURP. Patients and Methods This was a prospective cohort study on 83 BPH patients who underwent TURP at five hospitals in Bali, Indonesia. Trans-rectal ultrasonography (TRUS) was carried out to examine the prostate’s size. Three years after, we redo the TRUS examination to collect the data of the latest prostate size. TNF-α, TGF-β, serum PSA, testosterone, and age were registered for analysis. We used Pearson’s and Spearman’s correlation tests and multivariate analytic linear regression test (coefficient β) by SPSS 13.0 software. Results Age, testosterone, PSA, TNF-α, TGF-β were positively correlated to prostate’s volume progression. The prostate volume was strongly correlated with age (r= 0.749, p <0.001), PSA level (r=0.896, p <0.001), testosterone level (r=0.818, p <0.001), and TGF-β (r=0.609, p <0.001). The TNF-α level has a weak correlation to prostate’s volume progression (r=0.392, p <0.001). Conclusion TNF-α, TGF-β, PSA, testosterone, and age were significant as the risk factors in promoting the prostate volume progression after TURP.
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Affiliation(s)
| | | | | | | | - I Wayan Yudiana
- Department of Surgery, Faculty of Medicine, Udayana University, Bali, Indonesia
| | - Kadek Budi Santosa
- Department of Surgery, Faculty of Medicine, Udayana University, Bali, Indonesia
| | - Anak Agung Gde Oka
- Department of Surgery, Faculty of Medicine, Udayana University, Bali, Indonesia
| | | | - Christopher Ryalino
- Department of Anesthesiology, Faculty of Medicine, Udayana University, Bali, Indonesia
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Sagen E, Hedelin H, Nelzén O, Peeker R. Defining and discriminating responders from non-responders following transurethral resection of the prostate. Scand J Urol 2019; 52:437-444. [DOI: 10.1080/21681805.2018.1536677] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Erik Sagen
- Department of Urology, Hospital of Skaraborg, Skövde, Sweden
- Institute of Clinical Sciences at the Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Hans Hedelin
- Institute of Clinical Sciences at the Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Olle Nelzén
- Research and Development Centre, Hospital of Skaraborg, Skövde, Sweden
| | - Ralph Peeker
- Institute of Clinical Sciences at the Sahlgrenska Academy, University of Gothenburg, Sweden
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Belayneh M, Korownyk C. Treatment of lower urinary tract symptoms in benign prostatic hypertrophy with α-blockers. CANADIAN FAMILY PHYSICIAN MEDECIN DE FAMILLE CANADIEN 2016; 62:e523. [PMID: 27629686 PMCID: PMC5023361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Affiliation(s)
| | - Christina Korownyk
- Associate Professor in the Department of Family Medicine at the University of Alberta
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