Impact of Medical Treatment of Lower Urinary Tract Symptoms Suggesting Benign Prostatic Hyperplasia on Transurethral Resection of the Prostate

Impact of Medical Treatment of Lower Urinary Tract Symptoms Suggesting Benign Prostatic Hyperplasia on Transurethral Resection of the Prostate

Objective:
Medical therapy of lower urinary tract symptoms (LUTS) suggestive ofbenign prostatic hyperplasia (BPH) has fundamentally changed. The aim of the study is to verify the suggestion tkat the medical therapy delayed the need of operatioe treatment and led to changes in characteristics of patients in need of surgery, or whether it had possibly caused deterioration of the results of surgery.Materiál and methods: A group of 137 patients treated by TURP in 1991 (before medical therapy was introduced in Slovakia) was compared with a group of 122 patients treated by TURP in 2001 when medical therapy was offered as the primary initial therapy. We evaluated the patients age, co-morbidity, type and length of medical therapy of LUTS, indications for operation, the weight of the resected tissue, the length of urinary bladder drainage after the operation and the period of hospitalisation.Results: Patients in 2001 were on average 3.1 years older (p = 0.007), co-morbidity was present in 68.6 % patients in 1991 compared to 85.2 % in 2001 (not significant), and TURP for objective indications was done in 58.4% of patients in 1991 and in 50% in 2001. In 2001 71 out of 122 (58.2%) patients received medical therapy and 30 of them (24.6%) were operated on for objective indications. The weight of the resected tissue was 20.2 ± 13.2 grams in 1991 and 24.6 ± 15.4 grams in 2001 (p = 0.027). In 1991 the catheter was removed 4.5 ± 1.8 days after the operation compared to 3.1 ± 2.2 days in 2001 (p = 0.0001). The duration hospitalisation in 1991 was 7.7 ± 5.7 days compared to 5.2 ± 3.2 in 2001 (p = 0.0001).Conclusions: Patients receiving medical therapy have surgery at a higher age. The higher age of patients was not related to co-morbidity or the increased number of operations for objective indications, nor did the complications during surgery increase. On average more of the prostatic tissue was removed and the period of hospitalisation was shorter.

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