Hakenberg O W, Pinnock C B, Marshall V R
Department of Urology, University Hospital Dresden, Gemany.
BJU Int. 2003 Mar;91(4):375-9. doi: 10.1046/j.1464-410x.2003.04078.x.
To assess the value of preoperative symptom score assessment and pressure-flow measurement in men undergoing transurethral prostatectomy (TURP).
In a prospective study, 95 men (mean age 74.3 years) scheduled for TURP because of their lower urinary tract symptoms, flow rates and urinary residual volumes were assessed using the self-administered International Prostate Symptom Score (IPSS) and urodynamic pressure-flow studies. At 3 months after TURP the patients were reassessed with a flow rate measurement and the IPSS. The baseline IPSS and urodynamic values were analysed with respect to the endpoints of the study, flow rate and IPSS after TURP, and the improvements thereof, respectively.
There were significant improvements in mean IPSS (- 10.87 points) and peak flow rate (+ 7.06 mL/s) 3 months after TURP. Classifying the patients into subgroups with distinctly different initial values for IPSS, flow rate, residual urine volume and degree of obstruction (as expressed by Abrams-Griffiths number) showed that the flow rate and degree of obstruction influenced the improvement in flow rate but not in symptoms after TURP. Symptom improvement was only related to the initial level of symptoms. In a multivariate analysis, only age was an independent predictor of the outcome variables of flow rate and symptoms.
Clinical decision-making remains a valid instrument for selecting patients for TURP. Both the IPSS and pressure-flow assessment are useful to exclude patients who are unlikely to benefit from TURP. Age is an important predictor of the improvement in symptoms and flow rates after TURP for the lower urinary tract symptom complex associated with benign prostatic enlargement.
评估术前症状评分评估和压力 - 流率测量在接受经尿道前列腺切除术（TURP）的男性患者中的价值。
在一项前瞻性研究中，95名男性（平均年龄74.3岁）因下尿路症状计划接受TURP，使用自我管理的国际前列腺症状评分（IPSS）和尿动力学压力 - 流率研究评估其流速和残余尿量。在TURP术后3个月，对患者进行流速测量和IPSS重新评估。分别针对研究终点、TURP术后的流速和IPSS及其改善情况，分析基线IPSS和尿动力学值。
TURP术后3个月，平均IPSS（-10.87分）和最大尿流率（+7.06 mL/s）有显著改善。将患者按IPSS、流速、残余尿量和梗阻程度（用Abrams - Griffiths数表示）的初始值明显不同分为亚组，结果显示流速和梗阻程度影响TURP术后流速的改善，但不影响症状改善。症状改善仅与初始症状水平相关。在多变量分析中，只有年龄是流速和症状结局变量的独立预测因素。
临床决策仍是选择TURP患者的有效手段。IPSS和压力 - 流率评估均有助于排除不太可能从TURP中获益的患者。对于与良性前列腺增生相关的下尿路症状复合体，年龄是TURP术后症状和流速改善的重要预测因素。
