Analysis of prognostic factors regarding the outcome after a transurethral resection for symptomatic benign prostatic enlargement
Analysis of prognostic factors regarding the outcome after a transurethral resection for symptomatic benign prostatic enlargement
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DOI：
10.1002/nau.20262
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发表时间：
2006-01-01
影响因子：
2
通讯作者：
Naito, Seiji
中科院分区：
文献类型：
--
作者：
Seki, Narihito;Takei, Mineo;Naito, Seiji
目的：确定有症状的良性前列腺肥大（BPE）患者经尿道前列腺切除术（TURP）后治疗结局的术前预测变量。方法：对1,397例因症状性BPE接受TURP的384例患者进行回顾性研究。所有患者术前均完成国际前列腺症状评分（I-PSS）、生活质量（QOL）指标评估，并进行完整的尿动力学检查。在术后12个月评估结局。对基线变量与结局变量改善之间的相关性进行统计学分析。结果如下：术前尿动力学异常包括膀胱出口梗阻（BOO）315例（82.0%），逼尿肌活动不足91例（23.7%），逼尿肌活动过度（DO）160例（41.7%）。多因素分析显示，存在DO和BOO程度较高均与术后I-PSS和QOL改善相关。储存症状的初始水平与QOL的改善相关。结论：在大量有症状的BPE患者中，通过术前进行尿动力学分析获得的这些变量与TURP后下尿路症状和QOL改善程度之间的相关性在统计学上得到了阐明。较高程度的基线BOO阳性预测术后I-PSS和QOL的改善，而基线DO阴性预测。
Aims: To identify preoperative predictive variables regarding treatment outcomes following transurethral resection of the prostate (TURP) of patients with symptomatic benign prostatic enlargement (BPE). Methods: A retrospective study was conducted in 384 patients of 1,397 men who had undergone TURP for symptomatic BPE. All the patients had completed the evaluation of International Prostate Symptom Score (I-PSS), and quality of life (QOL) index, and had undergone full urodynamics before the surgery. Outcomes were assessed at 12 months after surgery. The association between baseline variables and the improvement in outcome variables was statistically analyzed. Results: Preoperative urodynamic abnormalities included bladder outlet obstruction (BOO) in 315 (82.0%), detrusor underactivity in 91 (23.7%), and detrusor overactivity (DO) in 160 (41.7%). Multivariate analysis showed that the presence of DO and a higher degree of BOO were both associated with postoperative improvement both in I-PSS and the QOL. The initial level of storage symptoms correlated with an improvement in the QOL. Conclusions: The association between those variables obtained by preoperatively performed urodynamic analysis and the degree of improvement in lower urinary tract symptom and QOL following TURP was statistically elucidated in a large number of patients with symptomatic BPE. A higher degree of baseline BOO positively predicts the postoperative improvement in I-PSS and QOL, while the baseline DO negatively predict it.