Urology Department, Centro Hospitalar Universitário Lisboa Norte, Lisbon.
Urology Department, Centro Hospitalar Universitário Lisboa Norte, Lisbon; Urology University Clinic, Faculty of Medicine, University of Lisbon.
Arch Ital Urol Androl. 2022 Jun 29;94(2):169-173. doi: 10.4081/aiua.2022.2.169.
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.
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.
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).
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.
经尿道前列腺切除术（TURP）仍然是治疗良性前列腺增生/下尿路症状的金标准手术之一。完全切除前列腺腺瘤的效果值得怀疑，有研究报告称，无论前列腺体积如何，切除组织的数量对手术结果都没有影响。本研究旨在评估在梗阻程度较轻的患者中，是否可以考虑进行较少广泛的 TURP。
回顾性分析了一家大学医院 185 名接受 TURP 的男性患者的数据。收集的数据包括术前前列腺体积和最大尿流率（Qmax），以及切除的前列腺重量和术后 Qmax。根据术前 Qmax<10mL/s 和≥10mL/s 将患者分为两组。
在术前 Qmax<10mL/s 的患者组中，发现切除的前列腺重量绝对值与术后 Qmax 之间存在相关性（r2=0.038，p=0.032），而与术前前列腺体积无关。在术前 Qmax≥10mL/s 的患者组中（r2=-0.033，p=0.796）或在整个人群分析中（r2=0.019，p=0.064）均未观察到这种相关性。同样，在术前 Qmax<10mL/s 的患者组中，Qmax 的改善与切除的前列腺重量绝对值和切除的前列腺重量百分比相关（r2=0.036，p=0.037 和 r2=0.040，p=0.029）。在术前 Qmax≥10mL/s 的患者组中，未发现这些相关性（r2=0.009，p=0.463 和 r2=-0.018，p=0.294）。
术前 Qmax≥10mL/s 的患者可能可以接受较不彻底的前列腺切除术，而术前 Qmax 较低的患者似乎受益于完全切除前列腺腺瘤。
