Abstract
Purpose: This study explores the predictive value of noninvasive urodynamic parameters for the efficacy of transurethral resection of the prostate (TURP). Methods: A total of 121 cases were divided into two groups. Benign prostatic hyperplasia (BPH) patients were assessed retrospectively and were divided into good prognosis (group A) and poor prognosis (group B) according to the degree of improvement in maximum urinary flow rate and the changes in ultrasound and noninvasive urodynamic parameters between the two groups were explored. Results: The PV, IPP, and PVR of group A were lower than those of group B (p < 0.05), and the Qmax of group A was more excellent than that of group B (p < 0.05). The difference was statistically significant (p < 0.05). There was no significant difference in DWT, age, and IPSS (p > 0.05). The ROC curve analyzes the diagnostic efficacy of each parameter in the diagnosis of the effectiveness of TURP. The results are ranked in order of 1/Qmax (AUC = 0.777), PV (AUC = 0.715), PVR (AUC = 0.642), and IPP (AUC = 0.629), of which 1/Qmax has the best diagnostic efficiency with AUC = 0.777, the best cutoff value is 0.12, the sensitivity is 0.81, and the specificity is 0.571. Conclusion: Preoperative application of noninvasive urodynamic parameters in BPH patients can better predict postoperative efficacy; especially, Qmax has the best predictive effect.
References
Langan RC. Benign Prostatic Hyperplasia. Prim Care. 2019 Jun; 46(2):223-232. https://doi.org/10.1016/j.pop.2019.02.003
Madersbacher S, Sampson N, Culig Z. Pathophysiology of Benign Prostatic Hyperplasia andBenign Prostatic Enlargement: A Mini-Review. Gerontology. 2019;65(5):458-464. https://doi.org/10.1159/000496289
Dornbier R, Pahouja G, Branch J, McVary KT. The New American Urological Association BenignProstatic Hyperplasia Clinical Guidelines: 2019 Update. Curr Urol Rep. 2020 Jul 1;21(9):32. https://doi.org/10.1007/s11934-020-00985-0
Gilling P, Barber N, Bidair M, Anderson P, Sutton M, Aho T, et al. WATER: A Double-Blind, Randomized,Controlled Trial of Aquablation vs Transurethral Resection of the Prostate in Benign Prostatic Hyperplasia. J Urol. 2018 May; 199(5):1252-1261. https://doi.org/10.1016/j.juro.2017.12.065
Kim M, Jeong CW, Oh SJ. Effect of urodynamic preoperative detrusor overactivity on the outcomes of transurethral surgery in patients with male bladder outlet obstruction: a systematic review and meta-analysis. World J Urol. 2019 Mar;37(3):529-538. https://doi.org/10.1007/s00345-018-2402-8
Abelson B, Majerus S, Sun D, Gill BC, Versi E, Damaser MS. Ambulatory urodynamic monitoring: state of the art andfuture directions. Nat Rev Urol. 2019 May; 16(5):291-301. https://doi.org/10.1038/s41585-019-0175-5
Suhani, Gupta S, Gupta A, Saha S, Mahapatra L, Srivastava U. Outcome of surgery for benign prostatic hyperplasia-is itpredictable? J Clin Diagn Res. 2013 Dec;7(12):2859-62. https://doi.org/10.7860/jcdr/2013/7606.3888
Foo KT. What is a disease? What is the disease clinical benign prostatic hyperplasia(BPH)? World J Urol. 2019 Jul;37(7):1293-1296. https://doi.org/10.1007/s00345-019-02691-0
Devlin CM, Simms MS, Maitland NJ. Benign Prostatic Hyperplasia‐ What do we know? BJU Int. 2021 Apr;127(4):389-399.https://doi.org/10.1111/bju.15229
Rahman F, Putra IB, Mochtar CA, Rasyid N. Adherence of Indonesian urologists to practice guidelines for the Management of benign prostatic hyperplasia. Prostate Int. 2019 Mar;7(1):35-40. https://doi.org/10.1016/j.prnil.2018.01.003
Foster HE, Dahm P, Kohler TS, Lerner LB, Parsons JK, Wilt TJ, Surgical Managemen tOf Lower Urinary Tract Symptoms Attributed To Benign Prostatic Hyperplasia: Aua Guideline Amendment 2019. J Urol. 2019 Sep;202(3):592-598. https://doi.org/10.1097/ju.0000000000000319
Demirbas A, Gunseren KO, Bagcioglu M, Yucel MO. A Prediction Model of Operation Efficacy Using Protruding Prostate Lobe Volume in Patients Who Are Candidates for Transurethral Resection of Prostate. Urol Int. 2019;103(2):172-179. https://doi.org/10.1159/000501175
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