Raheel Muhammad, Ibrar Sadaqat, Khan Shehryar, Moeed Muhammad, Muhammad Raza, Tayyib Muhammad, Ali Liaqat, Sohail Muzzamil, Haseeb Abdul
Department of Urology and Transplantation, Institute of Kidney Diseases, Hayatabad Medical Complex, Peshawar, PAK.
Department of Surgery, Hayatabad Medical Complex Peshawar, Peshawar, PAK.
Cureus. 2025 Jul 3;17(7):e87207. doi: 10.7759/cureus.87207. eCollection 2025 Jul.
Transurethral resection of the prostate (TURP) is an established treatment option for benign prostatic hyperplasia (BPH) with bladder outlet obstruction. Recently, the intra-operative void score (IVS) has emerged as a potential objective tool for assessing TURP efficacy by evaluating irrigating fluid flow. This study aimed to investigate IVS's role in predicting outcomes of TURP.
This prospective observational study was conducted at the Institute of Kidney Diseases, Peshawar, Pakistan, from January to March 2025. Forty male patients aged ≥50 years with BPH underwent TURP. IVS was assessed by emptying the bladder, instilling 300 mL of glycine irrigation solution, and applying a standardized 50 newton force to the suprapubic area and the Void score was calculated both pre-resection and post-resection. Patients were stratified into two groups based on combined IVS (high vs low combined IVS) and based on post-resection IVS (high vs low post-resection IVS) and compared for outcomes. Our primary outcomes included a successful trial without catheter (STWOC) and catheter-free follow-up (CFF). Univariate and multivariable analyses were conducted with a significance level set at p<0.05.
This study examined 40 subjects who underwent TURP during the study period. The mean ± SD age was 63.8 ± 8.9 years, and the average prostate size was 70.5 ± 14.3 grams. Sixteen patients had a low combined IVS score, and 24 had a high combined IVS score. A total of 14 patients had a low post-resection IVS, and 26 had a high post-resection IVS. Among these groups, the study population demonstrated balanced baseline characteristics and similar comorbidity profiles (all p>0.05). Multivariable regression analysis demonstrated that high combined IVS had 3.2-fold greater odds of STWOC (aOR=3.2, 95% CI:1.6-6.4, p=0.001) and 3.9-fold greater odds of CFF at six weeks (adjusted odds ratio (aOR)=3.9, 95% CI:1.7-8.9, p=0.002). Similarly, high post-resection IVS was independently associated with improved outcomes, including 2.8-fold greater odds of STWOC (aOR=2.8, 95% CI:1.3-6.0, p=0.008), 3.1-fold greater odds of CFF (aOR=3.1, 95% CI:1.2-8.0, p=0.02).
IVS represents a promising tool for real-time assessment of TURP efficacy and prediction of postoperative outcomes. Higher combined and post-resection IVS were associated with significantly higher odds of STWOC and CFF, representing much better outcomes. This simple scoring system could potentially improve surgical decision-making and patient counseling regarding expected outcomes following TURP.
经尿道前列腺切除术（TURP）是治疗伴有膀胱出口梗阻的良性前列腺增生（BPH）的一种成熟治疗选择。最近，术中排尿评分（IVS）已成为一种潜在的客观工具，可通过评估冲洗液流量来评估TURP的疗效。本研究旨在探讨IVS在预测TURP结局中的作用。
本前瞻性观察性研究于2025年1月至3月在巴基斯坦白沙瓦的肾病研究所进行。40名年龄≥50岁的BPH男性患者接受了TURP。通过排空膀胱、注入300 mL甘氨酸冲洗液，并对耻骨上区域施加标准化的50牛顿力来评估IVS，并在切除术前和切除术后计算排尿评分。根据联合IVS（高联合IVS与低联合IVS）和切除术后IVS（高切除术后IVS与低切除术后IVS）将患者分为两组，并比较结局。我们的主要结局包括无导尿管成功试验（STWOC）和无导尿管随访（CFF）。进行单因素和多因素分析，显著性水平设定为p<0.05。
本研究检查了40名在研究期间接受TURP的受试者。平均年龄±标准差为63.8±8.9岁，平均前列腺大小为70.5±14.3克。16名患者联合IVS评分低，24名患者联合IVS评分高。共有14名患者切除术后IVS低，26名患者切除术后IVS高。在这些组中，研究人群显示出平衡的基线特征和相似的合并症情况（所有p>0.05）。多因素回归分析表明，高联合IVS的STWOC几率高3.2倍（调整后比值比[aOR]=3.2，95%置信区间：1.6-6.4，p=0.001），六周时CFF几率高3.9倍（调整后比值比[aOR]=3.9，95%置信区间：1.7-8.9，p=0.002）。同样，高切除术后IVS与改善的结局独立相关，包括STWOC几率高2.8倍（aOR=2.8，95%置信区间：1.3-6.0，p=0.008），CFF几率高3.1倍（aOR=3.1，95%置信区间：1.2-8.0，p=0.02）。
IVS是实时评估TURP疗效和预测术后结局的一种有前景的工具。较高的联合IVS和切除术后IVS与STWOC和CFF的显著较高几率相关，代表了更好的结局。这种简单的评分系统可能会改善手术决策和患者关于TURP后预期结局的咨询。
