良性前列腺增生术后前列腺症状改善的相关影响因素分析

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Abstract Objective This study aimed to analyze the factors influencing improvement in prostate symptoms in patients with benign prostatic hyperplasia (BPH) treated with either bipolar transurethral resection of the prostate (BPRP) or holmium laser enucleation of the prostate (HoLEP). Methods We conducted a retrospective analysis of data from 240 patients diagnosed with BPH and treated between October 2018 and October 2021 at Tongji Hospital, Wuhan. Preoperative and postoperative data were reviewed, including urodynamic parameters in some patients, International Prostate Symptom Score (IPSS), Overactive Bladder (OAB) symptoms, Quality of Life (QoL) scores, surgical approach, and perioperative information. A telephone follow-up was performed at 6 months post-surgery to record relevant follow-up data. Among the 240 patients, 124 completed urodynamic examinations, and data from these patients were statistically analyzed to explore factors influencing postoperative improvement in prostate symptoms. Improvement in IPSS was defined as (postoperative/preoperative) ≤0.50, and patients were divided into the Improvement Group (Group A, 190 cases) and the Poor Improvement Group (Group B, 50 cases). Results All 240 patients who met the inclusion criteria had successful surgeries, with 178 patients undergoing HoLEP and 62 patients undergoing BPRP. Age, disease duration, BMI, FBG, TC, TG, AST, ALT, ALB, Csr, GFR, postoperative IPSS, preoperative and postoperative QoL, preoperative and postoperative OAB, surgical duration, indwelling catheter time, length of hospital stay, preoperative urinary retention, history of cardiovascular disease, history of cerebral infarction, history of diabetes, surgical approach, Qmax, FDV, PVR, Pqmax, SDV, BOOI, and BCI were not identified as risk factors for poor postoperative IPSS improvement. Prolonged disease duration (P<0.001), prostate volume (PV) (P=0.024), total prostate-specific antigen (TPSA) (P=0.002), free prostate-specific antigen (FPSA) (P=0.006), elevated preoperative IPSS (P=0.015), and decreased hemoglobin (Hb) (P=0.016) were identified as risk factors for poor postoperative IPSS improvement, with preoperative IPSS (P=0.006) and elevated PV (P=0.035) being independent risk factors. Conclusion Patients with larger prostate volumes and higher preoperative IPSS scores may experience poorer IPSS improvement after BPRP or HoLEP treatment for BPH. These patients should be counseled before surgery regarding the possibility of persistent prostate symptoms postoperatively, and medication may be necessary to alleviate symptoms if required.

Key words： benign prostatic hyperplasia prostate volume urodynamics prostate-specific antigen

Received: 12 September 2023

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R697+.3

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	LI Bei
	CHEN Yuan
	ZHANG An

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LI Bei,CHEN Yuan,ZHANG An. Analysis of Factors Influencing Improvement in Prostate Symptoms After Benign Prostatic Hyperplasia Surgery[J]. HuNan ShiFan DaXue XueBao(YiXueBan), 2023, 20(6): 55-59.

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http://yxb.hunnu.edu.cn/EN/ OR http://yxb.hunnu.edu.cn/EN/Y2023/V20/I6/55

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