Asian Journal of Research and Reports in Urology

A Comparative Study of Post Turp Outcomes and Complications between Benign Prostatic Hyperplasia Patients, Presenting with and without Acute Urinary Retention

Lingesh Sairam Chelliah *

Government Medical College Thiruvananthapuram Hospital Medical College Junction, Chalakkuzhi, Thiruvananthapuram, Kerala 695011, India.

Sathish Kumar G.

Government Medical College Thiruvananthapuram Hospital Medical College Junction, Chalakkuzhi, Thiruvananthapuram, Kerala 695011, India.

*Author to whom correspondence should be addressed.

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Abstract

Introduction: Benign Prostate Hyperplasia, BPH most common in elderly people are most   common causes of lower urinary tract symptoms. Failure to recognize these symptoms                     leads to progression of disease process that may ultimately lead to Acute urinary retention.                     An analysis of post TURP complications between patients presenting with and without AUR was done. And found that early intervention helped in preventing better recovery of patients with minimal acceptable complications than in those who had acute urinary retention and this study provides an educational insight to patients about the need of early intervention in patients presenting with LUTS

Aim and Objective of the Study: To compare the post TURP outcome and complications of Benign Prostatic Hyperplasia patients presenting with and without Acute Urinary Retention.

Materials and Methods: This is a prospective study. Patients with LUTS secondary to Benign Prostatic Hyperplasia and who presented with and without Acute Urinary Retention were included in the study. Patients were analyzed with detailed History & Physical examination, Digital Rectal Examination, S.PSA, USG KUB, Bladder Wall Thickness Uroflow & Post Void Residual urine. Patients who were more than 75 years, men with neurological disease, prostate cancer, urethral stricture, previous prostate or urethral surgery were excluded.

Post operative variables which were evaluated are Post op UTI, sepsis, Re-catheterisation rate , resurgery, onset of TUR syndrome, persistent hematuria requiring blood transfusion, post op stricture, LUTS, Q max, PVR and length of hospital stay, were compared between the two groups

Results: The study finding includes significant distribution in age distribution in patients presenting with and without acute urinary retention with patient in acute urinary retention being of advanced age and since they presented late they tend to have higher prostate volume with an associated increase in S.PSA and when these patients when undertaken for surgery tend to have increased post operative incidence of UTI and need for recatheterisation rate thereby causing prolonged hospital stay. Incidence of TUR syndrome Hematuria and need for blood transfusion were comparable between two groups.

Conclusion: Thus this study act as educational insight to patients stressing on the need for early intervention in BPH as incidence of age and associated complications like Post operative UTI and an increased need for Recatheterisation and prolonged hospital stay.

Keywords: Prostatic hyperplasia, lower urinary tract symptoms, post TURP complications

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References

Song Y, Gu Y, Guo H, Yang H, Wang X, Wu H, Wang A, Wang M, Wang H, Zhang Q, Liu L. Association between mean platelet volume and benign prostatic hyperplasia: A population study from the TCLSIH cohort study. Journal of Inflammation Research. 2023:3259-69.

Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, Bray F. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: A Cancer Journal for Clinicians. 2021;71(3):209-49.

De Nunzio C, Kramer G, Marberger M, Montironi R, Nelson W, Schröder F, Sciarra A, Tubaro A. The controversial relationship between benign prostatic hyperplasia and prostate cancer: The role of inflammation. European urology. 2011;60(1):106-17.

Zhang L, Wang Y, Qin Z, Gao X, Xing Q, Li R, Wang W, Song N, Zhang W. Correlation between prostatitis, benign prostatic hyperplasia and prostate cancer: a systematic review and meta-analysis. Journal of Cancer. 2020;11(1):177.

Devlin CM, Simms MS, Maitland NJ. Benign prostatic hyperplasia–what do we know? BJU international. 2021;127(4):389-99.

Chen JS, Chang CH, Yang WH, Kao YH. Acute urinary retention increases the risk of complications after transurethral resection of the prostate: A population-based study. BJU Int. 2012;110(11 Pt C):E896-901.

DOI: 10.1111/j.1464-410X.2012.11471.x Epub 2012 Oct 4

PMID: 23035623

Hutchison A, Farmer R, Chapple C, et al. Characteristics ofpatients presenting with LUTS/BPH in six European countries. Eur Urol. 2006;50:555–62

Briganti A, Capitanio U, Suardi N et al. Benign prostatic hyperplasia and its aetiologies. European Urology Supplements. 2009;8:865–871.

McConnell JD, Barry MJ, Bruskewitz RE, et al: Benign prostatic hyperplasia: Diagnosis and Treatment. Clinical Practice Guideline; 8.

Tan et al, Tan AH, Gilling PJ, Kennett KM, et al: A randomized trial comparing holmium laser enucleation of the prostate with TURP in large glands (40 to 200 grams). J Urol. 2003; 170:1270-1274.

Westenberg A, Gilling P, Kennett K, et al: Holmium laser resection of the prostate versus transurethral resection of the prostate: Results of a randomized trial with 4-year minimum long-term follow-up. J Urol. 2004;172:616-619. 85

Huang LK, Chang YH, Shao IH, Lee TL, Hsieh ML. Clinical outcome of immediate transurethral surgery for benign prostate obstruction patients with acute urinary retention: More radical resection resulted in better voiding function. J. Clin. Med. 2019;8:1278. DOI: 10.3390/jcm8091278