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Chung, Im, Kim, Jung, Kwon, Park, and Ryu: The Functional Effect of Palliative Transurethral Resection of the Prostate on Lower Urinary Tract Symptoms in Patients with Prostate Cancer
Original Article
Lower Urinary Tract Dysfunction
Korean Journal of Urology

Korean Journal of Urology 2009; 50(5): 445-449.

Published online: 25 May 2009

DOI: https://doi.org/10.4111/kju.2009.50.5.445

The Functional Effect of Palliative Transurethral Resection of the Prostate on Lower Urinary Tract Symptoms in Patients with Prostate Cancer

Ho Suck Chung, Chang Min Im, Sun-ouck Kim, Seung Il Jung, Dong Deuk Kwon, Kwangsung Park, Soo Bang Ryu

Department of Urology, Chonnam National University Medical School, Gwangju, Korea.

Correspondence to: Chang Min Im. Department of Urology, Chonnam National University Medical School, 8, Hak-dong, Doung-gu, Gwangju 501-757, Korea. TEL: 062-220-6700, FAX: 062-227-1643, ganglion72@hanmail.net

Received 6 January 2009       Accepted 16 April 2009

Copyright © The Korean Urological Association, 2009

Abstract

Purpose

Voiding dysfunction occurs frequently in patients with prostate cancer. We investigated the functional effect of palliative transurethral resection of the prostate (pTURP) on lower urinary tract symptoms in patients with prostate cancer.

Materials and Methods

We retrospectively assessed all patients who had a pTURP at our institution between 1999 and 2006. Patients with incidental prostate cancer were excluded. In all, 64 patients were enrolled in the study. The International Prostate Symptom Score (IPSS), the quality of life (QoL), the maximal flow rate (Qmax), and the postvoid residual urine volume (PVR) were evaluated before and after 3 months of pTURP. A positive functional outcome was defined as PVR below 100 ml, no additional catheterization, no repeat pTURP, and no development of urinary incontinence.

Results

The patients' mean age was 76.32±6.8 years, and their mean prostate volume was 46.38±19.43 g. After pTURP, the mean IPSS improved from 25.83±6.71 to 18.63±5.96, the mean QoL score improved from 4.33±0.87 to 3.02±0.83, the mean maximal flow rate increased from 6.11±3.68 ml/sec to 14.20±6.30 ml/sec, and the PVR decreased from 153.69±32.03 ml to 41.89±25.35 ml. All voiding parameters showed significant improvement (p<0.001). Of the 64 patients, 12 had poor functional outcome after pTURP. The functional improvement rate of pTURP was 81.25%.

Conclusions

The pTURP performed in patients with prostate cancer showed a favorable effect and resulted in significant improvement in voiding dysfunction. In patients with high-stage metastatic prostate cancer or cancer unsuitable for curative therapy, pTURP could be considered as a safe treatment method to improve lower urinary tract symptoms.

Keywords: Transurethral resection of prostate, Prostatic neoplasms, Treatment outcome

Figures and Tables

Table 1
Patients characteristics (n=64)
kju-50-445-i001

SD: standard deviation, PSA: prostate-specific antigen, a: measured by transrectal ultrasonography, b: palliative transurethral resection of the prostate and bilateral orchiectomy, if it was performed

Table 2
Comparison of the preoperative and postoperative outcomes
kju-50-445-i002

IPSS: International Prostate Symptom Score, QoL: quality of life, Qmax: maximal urine flow rate, PVR: postvoid residual urine volume

Table 3
Comparison of the preoperative and postoperative outcomes between the 2 groups
kju-50-445-i003

IPSS: International Prostate Symptom Score, QoL: quality of life, Qmax: maximal urine flow rate, PVR: postvoid residual urine volume

Table 4
Poor outcomes after palliative transurethral resection of the prostate (n=12)
kju-50-445-i004

a: three patients had postvoid residual volume of >100 ml before re-operation

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Kwangsung Park
https://orcid.org/http://orcid.org/0000-0001-8827-162X

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