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Effects of resection volume on postoperative micturition symptoms and retreatment after transurethral resection of the prostate

 Seung Han Shin  ;  Kwang Suk Lee  ;  Kyo Chul Koo  ;  Kang Su Cho  ;  Chang Hee Hong  ;  Byung Ha Chung  ;  Hyun Soo Ryoo  ;  Jae Hyun Ryu  ;  Yun Beom Kim  ;  Seung Ok Yang  ;  Jeong Kee Lee  ;  Tae Young Jung  ;  Jeong Woo Yoo 
 WORLD JOURNAL OF UROLOGY, Vol.41(11) : 3065-3074, 2023-11 
Journal Title
Issue Date
Humans ; Male ; Prostate / diagnostic imaging ; Prostate / surgery ; Prostatic Hyperplasia* / complications ; Retreatment ; Transurethral Resection of Prostate* / methods ; Treatment Outcome ; Urination
Benign prostatic hyperplasia ; International prostatic symptom score ; Resection volume ; Transurethral resection of the prostate
Purpose: Despite advances in technology, such as advent of laser enucleation and minimally invasive surgical therapies, transurethral resection of the prostate (TURP) remains the most widely performed surgical technique for benign prostatic hyperplasia (BPH). We evaluated resection volume (RV)-derived parameters and analyzed the effect of RV on post-TURP outcomes.

Methods: This observational study used data from patients who underwent TURP at two institutions between January 2011 and December 2021 Data from patients with previous BPH surgical treatment, incomplete data, and underlying disease affecting voiding function were excluded. The collected data included age, prostate-specific antigen, transrectal ultrasound (TRUS)- and uroflowmetry-derived parameters, RV, perioperative laboratory values, perioperative International Prostatic Symptom Score (IPSS), follow-up period, retreatment requirements and interval between the first TURP and retreatment.

Results: In 268 patients without prior BPH medication, there were no differences in prostate volume (PV), transitional zone volume (TZV), or RV according to IPSS. A total of 60 patients started retreatment, including medical or surgical treatment, within the follow-up period. There was a significant difference in RV/PV between the groups without and with retreatment respectively (0.56 and 0.37; p = 0.008). However, preoperative TRUS- and uroflowmetry-derived parameters did not differ between the two groups. Multiple linear regression analysis showed that RV (p = 0.003) and RV/TZV (p = 0.006) were significantly associated with differences in perioperative IPSS. In the multivariate logistic regression analysis, only RV/PV was correlated with retreatment (p = 0.010).

Conclusion: Maximal TURP leads to improved postoperative outcomes and reduced retreatment rate, it may gradually become a requirement rather than an option.
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1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
Koo, Kyo Chul(구교철) ORCID logo https://orcid.org/0000-0001-7303-6256
Lee, Kwang Suk(이광석) ORCID logo https://orcid.org/0000-0002-7961-8393
Chung, Byung Ha(정병하) ORCID logo https://orcid.org/0000-0001-9817-3660
Cho, Kang Su(조강수) ORCID logo https://orcid.org/0000-0002-3500-8833
Hong, Chang Hee(홍창희) ORCID logo https://orcid.org/0000-0002-0946-7702
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