Lombardo Riccardo, Ghezzo Nicola, Sarcinelli Luca, Turchi Beatrice, Zammitti Filippo, Franco Antonio, Nacchia Antonio, Cicione Antonio, Tema Giorgia, Pastore Antonio Luigi, Guarnotta Giorgio, Fuschi Andrea, Al Salhi Yazan, Tubaro Andrea, De Nunzio Cosimo
Department of Urology, Sapienza University of Rome, 00185 Rome, Italy.
Life (Basel). 2024 Mar 27;14(4):445. doi: 10.3390/life14040445.
The purpose of this study was to assess the importance of the post-void residual (PVR) ratio (PVR ratio) in achieving a favorable trifecta outcome for patients suffering from lower urinary tract symptoms and benign prostatic enlargement (LUTS-BPE) who undergo transurethral resection of the prostate (TURP). Starting from 2015, a series of patients with LUTS-BPE who underwent TURP were included in a forward-looking study. These patients were assessed using the international prostate symptom score (IPSS) screening tool, uroflowmetry, and a transrectal ultrasound to measure prostate volume (TRUS). Both the PVR urine volume and the PVR ratio (PVR-R), which is the PVR as a percentage of total bladder volume (voided volume + PVR), were measured. The assessment of outcomes was based on the trifecta favorable outcome, defined as meeting all of the following criteria: (1) absence of perioperative complications, (2) a postoperative IPSS of less than eight, and (3) a postoperative maximum urinary flow rate (Qmax) greater than 15 mL/s. A total of 143 patients were included, with a median age of 70 years (interquartile range 65-73). Of these, 58% (83/143) achieved a positive trifecta outcome. Upon conducting a multivariate analysis, both IPSS and Qmax were identified as predictors of a positive trifecta outcome, whereas the PVR-R did not prove to be an independent predictor. In summary, it was found that preoperative IPSS and Qmax are indicative of a trifecta outcome following TURP, whereas PVR-R is not.
本研究的目的是评估残余尿量(PVR)比率(PVR比率)对于患有下尿路症状和良性前列腺增生(LUTS - BPE)并接受经尿道前列腺切除术(TURP)的患者实现良好三联预后的重要性。从2015年开始,一系列患有LUTS - BPE并接受TURP的患者被纳入一项前瞻性研究。这些患者使用国际前列腺症状评分(IPSS)筛查工具、尿流率测定以及经直肠超声来测量前列腺体积(TRUS)进行评估。同时测量PVR尿量以及PVR比率(PVR - R),PVR - R是指PVR占膀胱总体积(排尿量 + PVR)的百分比。预后评估基于三联良好预后,定义为满足以下所有标准:(1)无围手术期并发症,(2)术后IPSS小于8,以及(3)术后最大尿流率(Qmax)大于15 mL/s。总共纳入了143例患者,中位年龄为70岁(四分位间距65 - 73)。其中,58%(83/143)实现了三联阳性预后。在进行多变量分析时,IPSS和Qmax均被确定为三联阳性预后的预测指标,而PVR - R并未被证明是一个独立的预测指标。总之,研究发现术前IPSS和Qmax可指示TURP后的三联预后,而PVR - R则不然。