Determining the correlation between transition zone index with international prostate symptom score and peak flow rate on                      clinical outcome after transurethral resection of the prostate in benign prostatic hyperplasia

Nalinikanta Mohanty; Samir Swain; Arshad Hasan; Gyanprakash Singh; Datteswar Hota

doi:10.18203/2349-2902.isj20195423

Authors

Nalinikanta Mohanty Department of Urology, SCB Medical College and Hospital, Cuttack, Odisha, India
Samir Swain Department of Urology, SCB Medical College and Hospital, Cuttack, Odisha, India
Arshad Hasan Department of Urology, SCB Medical College and Hospital, Cuttack, Odisha, India
Gyanprakash Singh Department of Urology, SCB Medical College and Hospital, Cuttack, Odisha, India
Datteswar Hota Department of Urology, SCB Medical College and Hospital, Cuttack, Odisha, India

DOI:

https://doi.org/10.18203/2349-2902.isj20195423

Keywords:

BPH, TZ, LUTS, IPSS, TURP

Abstract

Background: Benign prostatic hyperplasia (BPH) is a pathologic process which has common contribution to lower urinary tract symptoms (LUTS) in aging men. International Prostate Symptom Score (IPSS) is an important means of assesment in the clinical research of LUTS and BPH. Free flow rates (peak flow rate or Qmax) give an indirect measure for the probability of obstruction whereas subvesical obstruction only can be measured by invasive pressure-flow studies. Among the various surgical or minimally invasive techniques available for BPH like Intraprostatic stents (temporary/permanent), transurethral needle ablation (TUNA), transurethral microwave thermotherapy (TUMT), transurethral electrovaporization of prostate (TUVP), Transurethral incision of prostate (TUIP), lasers (Nd: YAG (Neodymium-doped yttrium aluminium garnet), Ho: YAG (Holmium yttrium aluminium garnet), potassium titanyl phosphate (KTP), diode, thulium laser) etc, transurethral resection of the prostate (TURP) is a safe and effective procedure. Comparison of difference in the pre and postoperative ultrasonic prostatic volume with amount of tissue resected at operation has established the accuracy of the method. The aims of present study are to determine the correlation between transition zone index with international prostate symptom score (IPSS) and peak flow rate (Qmax) on clinical outcome after TURP in BPH patients.

Methods: A prospective study was conducted to determine the effect of the extent of tissue resection on symptom improvement after TURP in men and to evaluate any potential correlation between prostate size and outcome.

Results: Total of 52 patients studied prospectively. Transitional zone (TZ) index was found to have a significant correlation with the clinical outcome.

Conclusions: Symptomatic improvement after TURP will depend on the amount of tissue resected in terms of IPSS and peak flow rates.

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References

Barry MJ, Fowler Jr FJ. The American Urological Association symptom index for BPH. The Measurement Committee of the American Urological Association. J Urol. 1992;148(5):1549-57.

Campbell-Walsh Textbook of Urology, 11th edition, ch. 105, Elsevier; 2018: 2510-2515.

Hastak SM, Gammelgaard J, Holm HH. Transrectal ultrasonic volume determination of the prostate - a preoperative and postoperative study. J Urol. 1982;127:1115-8.

Rhodes T, Girman CJ, Jacobsen SJ, Roberts RO, Guess HA, Lieber MM, et al. Longitudinal prostate growth rates during 5 years in randomly selected community men 40-79 years old. J Urol. 1999;161:1174-9.

Park SB, Kim JK. Prostate Volume Measurement by TRUS Using Heights Obtained by Transaxial and Midsagittal Scanning: Comparison with Specimen Volume Following Radical Prostatectomy. Korean J Radiol. 2000;1:110-3.

Bapat SS, Purnapatre SS, Pai KV, Yadav P, Padhye A, Bodhe YG, et al. Does estimation of prostate volume by abdominal ultrasonography vary with bladder volume: A prospective study with transrectal ultrasonography as a reference. Indian J Urol. 2006;22:322-5.

Kang YJ, Kim KH, Seo Y, Lee KS. Effect of Transurethral Resection of the Prostate on Storage Symptoms in Patients with Benign Prostatic Hyperplasia of Less than 30 ml. World J Mens Health. 2013;31(1):64-69.

Hyoung Keun Park. Effect of the Ratio of Resected Tissue in Comparison With the Prostate Transitional Zone Volume on Voiding Function Improvement After TURP. 2012;79(1):202-6.

Gupta A, Aragaki C, Gotoh M, Masumori N, Ohshima S, Tsukamoto T, et al. Relationship between prostate specific antigen and indexes of prostate volume in Japanese men. J Urol. 2005;173(2):503-6.

Canto EI, Singh H, Shariat SF, Lamb DJ, Mikolajczyk SD, Linton HJ, et al. Serum BPSA outperforms both total PSA and free PSA as a predictor of prostatic enlargement in men without prostate cancer. Urology. 2004;63(5):905-10.

Antunes AA, Srougi M, Coelho RF, Leite KR, Freire GC. Transurethral resection of the prostate for the treatment of lower urinary tract symptoms related to benign prostatic hyperplasia: how much should be resected? Intbraz J Urol. 2009;35:683-91.

Milonas D, Matjošaitis A, Jievaltas M. Transition zone volume measurement--is it useful before surgery for benign prostatic hyperplasia? Medicina (Kaunas, Lithuania). 2007;43(10):792-7.

Milonas D. Significance of operative parameters on outcomes after transurethral resection of the prostate. Medicina (Kaunas, Lithuania). 2010;46(1):24-9.

Chen SS, Hong JG. The correlation between clinical outcome and residual prostatic weight ratio after transurethral resection of the prostate for benign prostatic hyperplasia. BJU Int. 2000;85(1):79-82.

Songra MC, Kumar R. A study on the correlation between clinical outcome and residual prostatic weight ratio after transurethral resection of the prostate for benign prostatic hyperplasia. IJU. 2004;20:P42-46.

Oranusi CK, Nwofor AE, Mbonu O. Correlation between international prostate symptom score and uroflowmetry in patients with benign prostatic hyperplasia. Niger J Clin Pract. 2017;20:454-8.

Jiang YH, Lin VCH, Liao CH, Kuo HC. International Prostatic Symptom Score — Voiding/Storage Subscore Ratio in Association with Total Prostatic Volume and Maximum Flow Rate Is Diagnostic of Bladder Outlet-Related Lower Urinary Tract Dysfunction in Men with Lower Urinary Tract Symptoms. PLoS ONE. 2013;8(3):e59176.

Roy A, Singh A, Sidhu DS, Jindal RP, Malhotra M, Kaur H, et al. New visual prostate symptom score versus international prostate symptom score in men with lower urinary tract symptoms: A prospective comparision in Indian rural population. Niger J Surg. 2016;22:111-7.