Intravesical prostatic protrusion as a predictor of outcome of transurethral resection of prostate for benign enlargement of prostate

Abstract

Transurethral resection of the prostate (TURP) is considered standard surgical therapy for benign enlargement of prostate (BEP). Transabdominal ultrasound measurement of intravesical prostatic protrusion (IPP) is a noninvasive method of assessing the severity of symptoms in patients with bladder outlet obstruction (BOO) due to prostatic enlargement. To evaluate the outcome of transurethral resection of prostate in a patient with benign enlargement of prostate with intravesical prostatic protrusion. This quasi-experimental study was conducted from January, 2021 to December, 2021 in department of urology, Dhaka Medical College Hospital, Dhaka. A total of seventy-eight patients (age 50-70 years) admitted for TURP due to BEP with IPP were purposively selected for the study. Patients were divided into two groups according to their IPP grade: group-I includes IPP of ≥ 5mm (significant group) and group-II includes IPP of ˂ 5mm (non- Significant group). Lower Urinary Tract Symptoms (LUTS) severity were scored by the International Prostate Symptom Score (IPSS). Postoperatively, changes in IPSS, IPSS-v, IPSS-s, Quality of life (QoL) score, maximum urinary flow rate (Q max), and post void residual (PVR) at one month and three months after the operations were recorded in a predesigned data collection sheet. The mean ages of the patients were 61.9±4.5 and 61.5±5.6 years in group I and group II respectively. Preoperatively, there was significant statistical difference between the groups regarding IPSS, IPSS-v, IPSS-s, QoL score (p< 0.001), Q max (p = 0.008), and PVR (p = 0.026). After three months of operation (TURP), mean score of the IPSS, IPSS-v, IPSS-s, Qol and PVR were significantly lower and mean score of Q max was significantly higher in group I compared to that of group II (p< 0.05). The mean changes in IPSS, IPSS-v, IPSS-s, Qol, Q max and PVR were also significantly greater in group I compared to group II (p< 0.05). In this study, patients with IPP ≥ 5 mm experienced greater symptom improvement following TURP compared with patients with IPP < 5 mm.