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Abstract
Purpose
Cystourethroscopy provides information on the cause, size and severity of obstruction and the patency of the bladder neck, prostatic occlusion of the urethra and the estimated prostatic size. We evaluated the relationship between the prostatic morphology on the cystourethroscopic findings and the clinical findings and the outcomes of transurethral resection of the prostate (TURP).
Materials and Methods
We evaluated 291 patients who underwent TURP between January 1999 and June 2004. The prostate volume, the preoperative maximal flow rate (MFR), the postvoid residual urine volume (PVR) and the International Prostate Symptom Score (IPSS) were determined. The patients were divided into 4 groups by the cystourethroscopic findings before TURP: group I - isolated middle lobe enlargement, group II - isolated lateral lobe enlargement, group III - middle and lateral lobe enlargement, group IV - posterior commissural hyperplasia (median bar type).
Results
The analyses included 250 patients who had a mean age of 71.2 years, a mean prostate volume of 46.2g, a mean preoperative MFR of 7.8ml/s, a PVR of 73.1ml and an IPSS of 25.6. The prostate volume was larger in group II and III than in group l. The preoperative MFR and IPSS were not correlated with the prostatic morphology, but the storage symptom score was significantly higher in group IV. The postoperative parameters were not correlated with the prostatic morphology noted on cystourethroscopy.
Conclusions
The cystourethroscopic findings are not prognostic factors for the expected surgical outcomes in TURP. TURP is a good surgical therapeutic tool for treating benign prostatic hyperplasia regardless of the prostatic morphology seen on cystourethroscopy. Cystourethroscopy might need to be performed only in limited cases.
Figures and Tables
Fig. 1
Gross appearance of hyperplastic prostatic gland. I: isolated middle lobe enlargement, II: isolated lateral lobe enlargement, III: middle and lateral lobe enlargement, IV: posterior commissural hyperplasia.
Fig. 2
Comparison of the preoperative and postoperative symptom scores between groups. IPSS: International Prostate Symptom Score, *: p<0.05 by Duncan's multiple comparison test.
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