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Impact of intravesical prostatic protrusion and pathological type on transurethral resection of the prostate for benign prostatic hyperplasia

Zhe Liu, Jia Chen, Qiang Lu

Objective: To investigate the impact of intravesical prostatic protrusion and pathological type on TURP for benign prostatic hyperplasia (BPH).

Methods: Totally 158 cases with BPH were enrolled, then divided into the IPP significant group (n=70) and IPP non-significant group (n=88) according to the degree of intravesical prostatic protrusion (IPP), and patients were also divided into the glandular group (n=46), adenomyoma group (n=32), fibroadenoma group (n=58), fibrovascular group (n=22) according to the results of pathological features. The total prostate volume (TPV), the changes of international prostate symptom score (IPSS), maximum urinary flow rate (ΔQmax) and post-voiding residual urine volume output (ΔPVR), the operation time and intraoperative blood loss of IPP significant group and IPP non-significant group were compared before operation and 6 months after operation. The TPV, operation time, intraoperative blood loss, microvessel density (MVD), prostate specific antigen (PSA), ΔIPSS, ΔQmax and ΔPVR were compared between different pathological type of BPH, and analyzed the correlation among these parameters.

Results: The operation time and IPSS score of IPP significant group were significantly higher than that of IPP non-significant group (P<0.05). The operation time and intraoperative blood loss of glandular group and fibrovascular group were higher than those of adenomyoma group and fibroadenoma group (P<0.05). MVD of fibrovascular group were significantly higher than those of other three groups, and MVD in glandular group and adenomyoma group were significantly higher than those in fibroadenoma group (P<0.05), and difference of the PSA level among the four groups was statistical (P<0.05). The IPP were correlated with operation time and ΔIPSS score (P<0.05). The MVD and PSA were correlated with operation time (P<0.05) and intraoperative blood loss (P<0.05).

Conclusion: The IPP has correlation with operation time and intraoperative blood loss, the conbined evaluation of IPP and pathological type can predict the difficulty and efficacy of TURP, which has application value.