Department of Urology, Konkuk University School of Medicine, Seoul, Korea.
Urology. 2012 Jan;79(1):202-6. doi: 10.1016/j.urology.2011.07.1397. Epub 2011 Oct 19.
Few studies exist correlating the extent of tissue resected with symptom improvement after transurethral resection of prostate (TURP). This study evaluated the effect of the ratio of resected tissue in comparison with the transitional zone volume (TZV) on improvement of voiding symptoms and flow rate.
A total of 263 patients who underwent TURP from January 2001 to June 2008 were included in this retrospective study. TURP efficacy was assessed at 6 months using International Prostate Symptom Score (IPSS) and uroflowmetry. Patients were then stratified into 2 subgroups according to resection ratio (volume of resected tissue/TZV); individuals with resection ratio<50% (group A) and ≥50% (group B). The 2 groups were compared with regard to prostate volume, TZV, preoperative and postoperative IPSS, quality of life (QoL), peak flow rate (Qmax), and postvoid residual (PVR). Similar analyses were performed according to prostate volume (small [<40 g] vs large [≥40 g]).
Of these individuals, 85 (32.3%) met the criteria for group A, and 178 (67.7%) for group B. There were no statistically significant differences in age, prostate volume, TZV, preoperative IPSS, QoL score, Qmax, and PVR. After TURP, there was no significant difference of IPSS, QoL score, Qmax, and PVR between the 2 groups. After stratification according to prostate size, the differences in clinical variables were not significant according to resection ratio.
Resection ratio had no effect on post-TURP clinical improvement. These results suggest that complete prostate adenoma resection may not be essential.
经尿道前列腺切除术(TURP)后,与症状改善相关的组织切除范围的研究较少。本研究评估了与移行区体积(TZV)相比切除组织的比例对排尿症状和流量改善的影响。
本回顾性研究共纳入 2001 年 1 月至 2008 年 6 月期间接受 TURP 的 263 例患者。采用国际前列腺症状评分(IPSS)和尿流率评估 TURP 术后 6 个月的疗效。然后,根据切除比例(切除组织的体积/TZV)将患者分为 2 个亚组:切除比例<50%(A 组)和≥50%(B 组)。比较两组患者前列腺体积、TZV、术前和术后 IPSS、生活质量(QoL)评分、最大尿流率(Qmax)和残余尿量(PVR)。根据前列腺体积(<40g[小]和≥40g[大])进行类似的分析。
其中 85 例(32.3%)符合 A 组标准,178 例(67.7%)符合 B 组标准。两组患者的年龄、前列腺体积、TZV、术前 IPSS、QoL 评分、Qmax 和 PVR 均无统计学差异。TURP 后,两组患者的 IPSS、QoL 评分、Qmax 和 PVR 均无显著差异。根据前列腺大小分层后,根据切除比例,临床变量的差异不显著。
切除比例对 TURP 后临床改善无影响。这些结果表明,完全切除前列腺腺瘤可能并非必需。