Weng Da-Fei, Rui Hua, Zhou Wei-Min, Yuan Xue-Feng, Li Hai-Bo, Qin Zhen-Qian
Department of Urology, Yixing People's Hospital, Yixing, Jiangsu 214200, China.
Zhonghua Nan Ke Xue. 2021 Nov;27(11):1011-1016.
To evaluate preoperative comprehensive examinations of the IPSS-voiding to storage subscore ratio (IPSS-V/S), maximum urinary flow rate (Qmax), intravesical prostatic protrusion (IPP) and postvoid residual urine volume (PVR) in predicting the outcome of transurethral resection of the prostate (TURP) for BPH.
This retrospective study included 103 cases of BPH treated by TURP in Yixing People's Hospital from December 2018 to December 2019. The patients averaged 71.92 ± 7.73 years of age, with a mean prostate volume of (58.34 ± 15.59) ml, preoperative IPSS of 23.38 ± 3.36, voiding score of 14.38 ± 2.69, storage score of 9 (8－10), V/S ratio of 1.67 (1.43－1.88), Qmax of 7 (5－8) ml/s, IPP of 4 (0－5) mm, and PVR of (117.03 ± 20.51) ml. The TURP operations were completed by the same surgeon, with mean operation time of (83.65 ± 14.31) min and intraoperative blood loss of (55.32 ± 18.92) ml. The patients were followed up for 3 months after surgery for evaluation of the outcomes based on the IPSS and quality of life (QOL) scores.
The postoperative IPSS was significantly improved in all the patients compared with the baseline (5.36 ± 1.95 vs 23.38 ± 3.36, P < 0.05). Based on the criteria of IPSS < 7 and general satisfaction with QOL, satisfactory results were achieved in 71 (68.93%) of the patients (aged 71.04 ± 7.23 years, prostate volume: ［59.68 ± 15.79］ ml, IPSS: 23.87 ± 3.42, voiding score: 14.87 ± 2.34, storage score: 9 ［8－10］, V/S ratio: 1.67 ［1.47－1.86］, Qmax: 6 ［4－7］ ml/s, IPP: 5 ［0－6］ mm, PVR: 110.53 ± 17.69 ml, operation time ［85.37 ± 12.28］ min, intraoperative blood loss: ［58.08 ± 14.61］ ml), and unsatisfactory results in the other 32 (31.07%) (aged 76.91 ± 8.25 years, prostate volume: ［55.38 ± 14.73］ ml, IPSS: 22.53 ± 3.25, voiding score: 13.53 ± 3.21, storage score: 9 ［8－12］, V/S ratio: 1.36 ［1.03－1.95］, Qmax: 8 ［7－9］ ml/s, IPP: 0 ［0－5］ mm, PVR: ［129.61 ± 20.62］ ml, operation time: ［78.85 ± 10.04］ min, intraoperative blood loss: 48.76 ± 12.19 ml).
TURP yields better results in younger BPH patients, with baseline IPSS dominantly in urinary symptoms, greater IPP, lower PVR, and lower Qmax.
评估国际前列腺症状评分储尿期与排尿期评分比值（IPSS-V/S）、最大尿流率（Qmax）、膀胱内前列腺突入（IPP）及残余尿量（PVR）等术前综合检查指标对良性前列腺增生（BPH）行经尿道前列腺切除术（TURP）疗效的预测价值。
本回顾性研究纳入2018年12月至2019年12月在宜兴市人民医院接受TURP治疗的103例BPH患者。患者平均年龄71.92±7.73岁，平均前列腺体积（58.34±15.59）ml，术前IPSS为23.38±3.36，排尿期评分14.38±2.69，储尿期评分9（8 - 10），V/S比值1.67（1.43 - 1.88），Qmax为7（5 - 8）ml/s，IPP为4（0 - 5）mm，PVR为（117.03±20.51）ml。TURP手术均由同一术者完成，平均手术时间（83.65±14.31）min，并平均术中出血量（55.32±18.92）ml。术后对患者进行3个月随访，依据IPSS及生活质量（QOL）评分评估手术疗效。
与基线相比，所有患者术后IPSS均显著改善（5.36±1.95 vs 23.38±3.36，P<0.05）。按照IPSS<7且QOL总体满意的标准，71例（68.93%）患者手术效果满意（年龄71.04±7.23岁，前列腺体积：［59.68±15.79］ml，IPSS：23.87±3.42，排尿期评分：14.87±2.34，储尿期评分：9［8 - 10］，V/S比值：1.67［1.47 - 1.86］，Qmax：6［4 - 7］ml/s，IPP：5［0 - 6］mm，PVR：110.53±17.69 ml，手术时间［85.37±12.28］min，术中出血量：［58.08±14.61］ml），另外32例（31.07%）患者手术效果不满意（年龄76.91±8.25岁，前列腺体积：［55.38±14.73］ml，IPSS：22.53±3.25，排尿期评分：13.53±3.21，储尿期评分：9［8 - 12］，V/S比值：1.36［1.03 - 1.95］，Qmax：8［7 - 9］ml/s，IPP：0［0 - 5］mm，PVR：［129.61±20.62］ml，手术时间：［X78.85±10.04］min，术中出血量：48.76±12.19 ml）。
TURP对年轻BPH患者疗效更佳，此类患者基线IPSS以排尿期症状为主，IPP较大，PVR较低，Qmax较低。
