Abstract: PD27-07
Sources of Funding: none

Introduction

We investigated whether preoperative prostatic urethral angle (PUA) and intravesical prostatic protrusion (IPP) on transrectal ultrasonography (TRUS) were associated with the improvement of peak urinary flow rate after surgical treatment of benign prostatic enlargement (BPE) in patients with lower urinary tract symptoms.

Methods

A total of 173 men who underwent photoselective vaporization of prostate (PVP) for symptomatic BPE from August 2012 to March 2016 were retrospectively reviewed. Preoperative TRUS was performed and total prostatic volume, transitional zone volume were measured. According to the PUA, the patients were divided into two groups and comparatively analyzed. Surgical outcomes were assessed by the ratio of the international prostate symptom score (IPSS) / quality of life (QoL), the difference in the peak urinary flow rate (Qmax) / post-voided residual urine (PVR) before and at 1, 3, 6, 12, 24, 36 months postoperatively. Sucessful surgical outcome was defined to achievement of increase by ? 30% of Qmax after surgery compared to baseline.

Results

The 90 patients were in Group A (PUA < 48°) and 83 patients were in Group B (PUA (≥ 48°). The age, body mass index, prostatic specific antigen, total prostate volume, PVR, IPSS voiding symptom scores, storage symptom scores and QoL scores were comparable between two groups. However, the rate of IPP and Qmax showed significantly difference (P < 0.05). The successful improvement of Qmax was observed in 107 (61.8%) patients. Multivariate analysis revealed that preoperative IPP (OR 3.921(1.244-12.353), P = 0.020) and higher PUA (≥ 48°, OR 2.353(1.177-4.703), P = 0.015) were independent predictors of successful surgical outcome after PVP.

Conclusions

Preoperative higher PUA and IPP were the independent risk factors to the improvement of the peak urinary flow rate after surgical treatment of patients with symptomatic BPE. Larger scale prospective study is needed.

Funding

none