Does histological prostatic inflammation during transurethral resection of the prostate for bladder outlet obstruction affect post-operative urinary outcomes?

IF 1.5 4区医学 Q3 UROLOGY & NEPHROLOGY

LUTS: Lower Urinary Tract Symptoms Pub Date : 2023-01-23 DOI:10.1111/luts.12473

Bharti Arora, Munad Khan, Simon Pridgeon

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引用次数: 0

Abstract

Objective

Benign prostate hyperplasia (BPH) is a common cause for bladder outlet obstruction (BOO) and lower urinary tract symptoms (LUTS) in men. The pathophysiology of BPH is multifactorial and inflammation has been linked with progression of BPH and LUTS. The association between histological prostatitis found at transurethral resection of the prostate (TURP) and adverse post-operative urinary outcomes is not clearly defined. Our aim was to evaluate the association between histological prostatitis and adverse post-operative urinary outcomes following TURP procedure.

Methods

Patients who had undergone TURP for BPH at a single institution between 2014 and 2018 were included. The study population was divided into three cohorts: those with no histological inflammation, those with any form of inflammation and those specifically with prostatic stromal inflammation. Functional outcomes were assessed by defining a series of measurable post-operative “LUTS events” and comparing these to time-to-event profile using a Kaplan–Meier estimator.

Results

A total 198 patients were included (no inflammation n = 101; any inflammation n = 97, prostatic stromal inflammation n = 81). All three groups were comparable in terms of baseline characteristics. The any inflammation group had significantly more adverse post-operative outcomes after TURP compared to the no inflammation group, P = 0.0065. The stromal inflammation group had more LUTS events after surgery compared to the no inflammation groups in the first year of follow-up n = 0.011; over a 5-year follow-up period the results were not statistically significant, P = 0.244.

Conclusion

Histological prostatitis is associated with worse urinary outcomes after TURP compared to no inflammation. These results are useful in improving prognostic discussions with patients after TURP.

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经尿道前列腺切除术治疗膀胱出口梗阻时的组织学前列腺炎症是否影响术后泌尿预后?

目的良性前列腺增生(BPH)是男性膀胱出口梗阻(BOO)和下尿路症状(LUTS)的常见原因。BPH的病理生理是多因素的，炎症与BPH和LUTS的进展有关。经尿道前列腺切除术(TURP)中发现的组织学前列腺炎与术后泌尿系统不良预后之间的关系尚不明确。我们的目的是评估组织学前列腺炎与TURP手术后泌尿系统不良预后之间的关系。方法纳入2014年至2018年在单一机构接受前列腺增生手术的患者。研究人群被分为三组:没有组织学炎症的，有任何形式炎症的和有前列腺间质炎症的。通过定义一系列可测量的术后“LUTS事件”来评估功能结果，并使用Kaplan-Meier估计器将其与事件发生时间进行比较。结果共纳入198例患者(无炎症101例;任何炎症n = 97，前列腺基质炎症n = 81)。所有三组在基线特征方面具有可比性。与无炎症组相比，任何炎症组在TURP术后的不良预后明显增加，P = 0.0065。随访第一年间质炎症组术后LUTS事件发生率高于无炎症组n = 0.011;5年随访结果无统计学意义，P = 0.244。结论与无炎症相比，组织学前列腺炎与TURP术后尿路预后差相关。这些结果有助于改善TURP后患者的预后讨论。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

LUTS: Lower Urinary Tract Symptoms UROLOGY & NEPHROLOGY-

CiteScore

3.00

自引率

7.70%

发文量

审稿时长

>12 weeks

期刊介绍： LUTS is designed for the timely communication of peer-reviewed studies which provides new clinical and basic science information to physicians and researchers in the field of neurourology, urodynamics and urogynecology. Contributions are reviewed and selected by a group of distinguished referees from around the world, some of whom constitute the journal''s Editorial Board. The journal covers both basic and clinical research on lower urinary tract dysfunctions (LUTD), such as overactive bladder (OAB), detrusor underactivity, benign prostatic hyperplasia (BPH), bladder outlet obstruction (BOO), urinary incontinence, pelvic organ prolapse (POP), painful bladder syndrome (PBS), as well as on other relevant conditions. Case reports are published only if new findings are provided. LUTS is an official journal of the Japanese Continence Society, the Korean Continence Society, and the Taiwanese Continence Society. Submission of papers from all countries are welcome. LUTS has been accepted into Science Citation Index Expanded (SCIE) with a 2011 Impact Factor.