Is It Necessary to Remove the Maximum Prostate Tissue in All Patients? the Percentage of Resected Prostate Tissue and the Influence on Surgery Outcomes: A One-Year Follow Up Study.

Abstract

Introduction: To investigate whether the volume of the prostate tissue resected on TURP influences on short and medium term follow up.

Methods: It was developed a prospective study between May 2020 and August 2022, embracing patients with severe LUTS due to BPO, including clinical and urodynamic parameters meeting obstruction criteria (BOOI > 40), and good detrusor function (BCI > 100). Patients were assessed at 1, 6 and 12 months follow up. The primary endpoint was to compare whether the amount of resected tissue after TURP influences uroflowmetry at 12 months follow up (Qmax, ml/sec). The secondary endpoint was to compare different percentages of resected tissue (RPT) and its relation to the outcomes.

Results: Ninety-six patients with mean age of 70,4 ± 7.96 years. At baseline, prostate volume was 78.5 ± 51.8 cc³, Qmax was 6.03 ± 3.09 ml/sec and post void residual (PVR) was 113 ± 132 ml, IPSS of 24.9 ± 6.75. All of them were urodinamically obstructed (BOOI 86.7 ± 35.6) and good detrusor function (BCI 130 ± 28.6). The general RPT was 45.5 ± 27.7%. The higher the RTP, the lower the PSA at 1 month follow up (p < 0.001, R = 0.521). Nevertheless, it was not found correlation between the RTP and Qmax, IPSS or PVR.

Conclusion: TURP improves clinical and urodynamic parameters at 1 year follow up, independent of the amount of resected prostate tissue, in patients with bladder outlet obstruction and good detrusor function, since the surgery is effective.