Clinical Analysis Of TUERP In The Treatment Of DU Patients With Different Bladder Outlet Obstruction

Objective:By analysing the indicators before and after surgery for benign prostatic hyperplasia(BPH),the surgical efficacy of TUERP in patients with bladder detrusor damage(DU)under different degrees of bladder obstruction was investigated to provide clinicians with surgical decisions and to improve the understanding of DU among physicians and patients.Methods:This was a single-centre retrospective study,by collecting and screening clinical data of patients who underwent TUERP from June 2017 to June 2021 at Huaihe Hospital of Henan University a total of 166 patients,all of whom were operated on by the same surgeon.All patients had preoperative urodynamic studies(UDS)as well as urological ultrasound and other examination tests,and various scoring questionnaires were completed.Based on the values provided by the patients’ urodynamic results,the BOOI values and BCI values were calculated respectively by combining the bladder outlet obstruction index formula BOOI= Pdet Qmax-2×Qmax and the bladder contractility index formula BCI= Pdet Qmax +5×Qmax.Patients were divided according to the degree of BOOI into groups with BOOI < 20(nonobstruction),20 ≤ BOOI < 40(suspected obstruction),and BOOI ≥ 40(obstruction).only three patients in the BOOI < 20 group had special circumstances and the analysis may have been biased,so this group was excluded.The remaining two groups of patients were classified as DU according to the International Association of Urological Control’s criteria for the diagnosis of DU: patients with a BCI <100 were classified as DU and those with a BCI ≥100 were classified as non-DU for comparative analysis.The main study indicators for pre-and post-operative follow-up were IPSS-S,IPSS-V,IPSS-T,Qo L,f Qmax,and PVR,with a follow-up period of 3 months after surgery.The successful improvement of IPSS-series score was defined as ≥50% decrease from preoperative baseline after surgery,the successful improvement of Qo L score was defined as ≥ 3 points before surgery compared to after surgery,and the successful improvement of f Qmax was defined as ≥5.0ml/s after surgery compared to before surgery.Results:1.According to the diagnostic criteria of DU established by ICS,BCI <100 was diagnosed as DU.70 patients with DU and 96 patients without DU were diagnosed as DU.FPSA,f Qmax,PVR,MCC,Pves Qmax,Pdet Qmax,Pdetmax,BOOI and BCI were compared between the two groups with statistical significance(P < 0.05).According to the BOOI grouping,there were 3 cases in the BOOI <20 group(nonobstruction),which had a small sample size and this group was excluded.41 cases in the 20≤BOOI <40group(suspected obstruction)and 122 cases in the BOOI ≥40 group(obstruction)were compared between the two groups.Age,PV,f Qmax,PVR,MCC,Pves Qmax,Pdet Qmax,Pdetmax,Pdetmax,BOOI,and BCI were statistically significant(p < 0.05).2.There were 41 patients in the suspected obstruction group and 122 patients in the obstruction group.The difference between the two groups was statistically significant(P < 0.05)when comparing the postoperative indexes of the two groups compared to the preoperative indexes.The differences were statistically significant(P < 0.05)when comparing the postoperative indexes of the two groups and the success rate of improvement of the postoperative indexes.3.In the group with a BOOI of 20 to 40,there were 32 DU patients and 9 non-DU patients.The differences were statistically significant(P < 0.05)when comparing the post-operative indicators between the two groups of patients before surgery.The differences in the postoperative indexes between the two groups were statistically significant(P < 0.05).The difference was statistically significant(P < 0.05)when comparing the success rate of improvement of the postoperative indicators between the two groups.In the BOOI≥40 group,there were 35 DU patients and 87 non-DU patients.The differences were statistically significant(P < 0.05)when comparing the post-operative indexes between the two groups of patients before surgery.The difference in postoperative indexes between the two groups was statistically significant(P < 0.05).The difference was statistically significant(P < 0.05)when comparing the success rate of improvement of the postoperative indicators between the two groups of patients.Conclusion:1.Patients with different degrees of obstruction improved after TUERP,with patients with definite obstruction improving more than those with suspected obstruction.2.The degree of improvement after TUERP in DU patients with different degrees of obstruction is inferior to that in non-DU patients.The success rate of surgical improvement in DU patients with suspected obstruction is significantly lower and surgery should be chosen with caution.