Department of Urology, Taichung Veterans General Hospital, Taichung, Taiwan.
School of Medicine, National Chung Hsing University, Taichung, Taiwan.
PLoS One. 2023 Mar 9;18(3):e0282745. doi: 10.1371/journal.pone.0282745. eCollection 2023.
Transurethral resection of prostate (TURP) and laser prostate surgery are common surgeries for benign prostate hyperplasia (BPH). We conducted an investigation using hospital database to evaluate the clinical factors associated with post-operative usage of alpha-blockers and antispasmodics.
This study was conducted using retrospective clinical data from the hospital database, which contained newly diagnosed BPH patients between January 2007 and December 2012 who subsequently received prostate surgery. The study end-point was the use of alpha-blockers or antispasmodics for at least 3 months duration after 1 month of surgery. The exclusion criteria was prostate cancer diagnosed before or after the surgery, recent transurethral surgeries, history of open prostatectomy, and history of spinal cord injury. Clinical parameters, including age, body mass index, preoperative prostate specific antigen value, comorbidities, preoperative usage of alpha-blockers, anstispasmodics and 5-alpha reductase inhibitors, surgical methods, resected prostate volume ratios, and preoperative urine flow test results, were evaluated.
A total of 250 patients receiving prostate surgery in the database and confirmed pathologically benign were included. There was significant association between chronic kidney disease (CKD) and the usage of alpha-blockers after prostate surgery (OR = 1.93, 95% CI 1.04-3.56, p = 0.036). Postoperative antispasmodics usage was significantly associated with preoperative usage of antispasmodics (OR = 2.33, 95% CI 1.02-5.36, p = 0.046) and resected prostate volume ratio (OR = 0.12, 95% CI 0.02-0.63, p = 0.013).
BPH patients with underlying CKD were more likely to require alpha-blockers after surgery. In the meantime, BPH patients who required antispasmodics before surgery and who received lower prostate volume resection ratio were more liable to antispasmodics after prostate surgery.
经尿道前列腺切除术（TURP）和激光前列腺手术是治疗良性前列腺增生（BPH）的常见手术。我们利用医院数据库进行了一项调查，以评估与术后使用α受体阻滞剂和抗痉挛药物相关的临床因素。
本研究使用医院数据库中的回顾性临床数据进行，该数据库包含 2007 年 1 月至 2012 年 12 月期间新诊断为 BPH 的患者，随后接受了前列腺手术。研究终点是手术后 1 个月后至少使用 3 个月的α受体阻滞剂或抗痉挛药物。排除标准为手术前或手术后诊断为前列腺癌、近期经尿道手术、开放性前列腺切除术史和脊髓损伤史。评估了临床参数，包括年龄、体重指数、术前前列腺特异性抗原值、合并症、术前使用α受体阻滞剂、抗痉挛药物和 5α 还原酶抑制剂、手术方法、切除前列腺体积比以及术前尿流测试结果。
数据库中共有 250 例接受前列腺手术并经病理证实为良性的患者纳入研究。慢性肾脏病（CKD）与前列腺手术后使用α受体阻滞剂之间存在显著关联（OR=1.93，95%CI 1.04-3.56，p=0.036）。术后使用抗痉挛药物与术前使用抗痉挛药物（OR=2.33，95%CI 1.02-5.36，p=0.046）和切除前列腺体积比（OR=0.12，95%CI 0.02-0.63，p=0.013）显著相关。
患有基础 CKD 的 BPH 患者术后更有可能需要使用α受体阻滞剂。同时，术前需要抗痉挛药物且前列腺体积切除比例较低的 BPH 患者，术后更有可能使用抗痉挛药物。
