OBJECTIVE: To report the clinical characteristics of patients who have persistent lower urinary tract symptoms (LUTS) after surgery for benign prostatic hyperplasia (BPH) and continue their medical therapy postoperatively.
MATERIALS AND METHODS: We retrospectively studied 372 patients who underwent transurethral resection of prostate for LUTS/BPH in 8 institutions to determine the differences between patients who continued LUTS/BPH medications for >3 months after surgery and those who did not. Preoperative, intraoperative, and postoperative clinical parameters were assessed. The Student t test and chi square test were used to compare each parameter between patient groups. Multivariate logistic regression analysis was performed to identify risk factors for persistent LUTS and continuing medical therapy after surgery.
RESULTS: There were 205 patients (55.1%) who continued their LUTS/BPH medications for >3 months postoperatively. They reported poorer International Prostate Symptom Scores and uroflowmetry results after surgery. Multivariate analysis showed that age >70 years (odds ratio [OR], 2.474; P = .001), history of diabetes (OR, 1.949; P = .040), history of cerebrovascular accident (OR, 5.932; P = .001), any previous LUTS/BPH medication use (OR, 5.384; P = < 0.001), and previous antimuscarinic drug use (OR, 2.962; P = .016) were significantly associated with symptom persistency and continuing medical therapy.
CONCLUSION: Many patients have persistent voiding dysfunction after surgical treatment for LUTS/BPH. Older age, history of diabetes, history of cerebrovascular accidents, and preoperative antimuscarinic drug uses are possible risk factors.
Written by:
Han HH, Ko WJ, Yoo TK, Oh TH, Kim DY, Kwon DD, Byun SS, Kim SI, Jung TY. Are you the author?
Department of Urology, National Health Insurance Service Ilsan Hospital, Yonsei University College of Medicine, Goyang, Korea; Department of Urology, Eulji Medical Center, Eulji University School of Medicine, Seoul, Korea; Department of Urology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea; Department of Urology, Catholic University of Daegu School of Medicine, Daegu, Korea; Department of Urology, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Gwangju, Korea; Department of Urology, Seoul National University Bundang Hospital, Seongnam, Korea; Department of Urology, Ajou University School of Medicine, Suwon, Korea; Department of Urology, Veterans Health Service Medical Center, Seoul, Korea.
Reference: Urology. 2014 Jul 21. pii: S0090-4295(14)00396-3.
doi: 10.1016/j.urology.2014.04.027
PubMed Abstract
PMID: 25059592
