| Objective: For patients with benign prostatic hyperplasia(BPH)who have undergone transurethral resection of the prostate(TURP),the risk factors associated with the lack of significant improvement in lower urinary tract symptoms(LUTS)after the procedure were investigated to provide a reference for improving the therapeutic effect of TURP and the postoperative life quality of patients.Methods: The subjects of this study were 200 patients with BPH who completed TURP in the Department of Urology of Qingdao Municipal Hospital from January 2021 to January 2022,and various clinical data were collected during their hospitalization,including age,height,weight,preoperative international prostate symptom score(IPSS),preoperative maximum urine flow rate,preoperative prostate volume size,bladder residual urine volume(PVR),prostate-specific antigen(PSA),duration of surgery,intraoperative prostate removal mass size,postoperative duration of carrying ureter,and whether they were combined with hypertension,diabetes mellitus,coronary heart disease,prostatitis,Intravesical prostatic protrusion(IPP),secondary urinary tract infections,and whether they had physical exercise habits,etc.And their IPSS at 1 month and 3 months were assessed by telephone follow-up.Patients were divided into two groups based on their IPSS at 3 months after surgery,one group(IPSS<8)had significant improvement in LUTS,and the other group(IPSS≥8)had insignificant improvement in LUTS.Patients with insignificant improvement in LUTS completed medical examinations such as blood routine,urine routine,and urodynamics to assess the cause of abnormal urination.A retrospective study was conducted on its clinical data,and continuous metric data conforming to normal distribution were expressed as mean ± standard deviation and compared using the independent samples t-test,count data were expressed as the number of cases or percentage and compared using the test,and each factor that was statistically significant for univariate analysis was then subjected to binary logistic regression analysis to determine the final independent risk factor.Results: The 200 middle-aged and elderly male patients who obtained follow-up had an average age of 73.12 ± 8.61 years.Compared with the preoperative IPSS(23.89±5.20)of TURP,the IPSS(6.51±4.02)of patients at 1 month after the operation and the IPSS(5.80±3.63)at 3 months after operation were significantly different(p﹤0.05),and the difference was statistically significant,it indicates that the therapeutic effect of the TURP and the overall recovery of the patients after surgery was good.The group(IPSS<8)with significant improvement in LUTS after TURP totaled 174,accounting for 87.00%,and the other group(IPSS≥8)had a total of 26 people,accounting for 13.00%.Among them,20 patients mainly manifested symptoms during urine storage,accounting for 76.92%;4patients mainly manifested symptoms during urination,accounting for 15.38%;2 patients mainly manifested symptoms after urination,accounting for 7.69%.For the study of various clinical data in the two groups,the results of the univariate analysis showed: the influence of age(p=0.543),body mass index(p=0.374),preoperative prostate volume(p=0.851),rate of prostatectomy during operation(p=0.186),preoperative maximum urine flow rate(p=0.086),duration of ureter-carrying after the operation(p=0.121),diabetes mellitus(p=0.270),hypertension(p=0.926)and coronary heart disease(p=0.158)on the improvement of LUTS after TURP,the p-values were all greater than 0.05,the difference was not significant;While patients’ preoperative IPSS score(p<0.001),PVR(p<0.001)and whether they had combined prostatitis(p=0.002),whether they had secondary urinary tract infection(p=0.001),whether they had combined IPP(p=0.008),and whether they had physical exercise habit(p=0.013)on the improvement of LUTS after TURP,the p-value was less than 0.05,and the difference was statistically significant.The above statistically significant factors were again included in the logistic regression analysis,and the results showed that combined prostatitis(OR=4.77,95 CI% 1.15-19.80,p= 0.031),combined IPP(OR=3.53,95 CI% 1.20-10.37,p = 0.022),PVR(OR=1.01,95%CI 1.00-1.01,p = 0.003)and preoperative IPSS score(OR=1.19,95 CI% 1.07-1.33,p=0.001)were independent risk factors for LUTS insignificant improvement after TURP.Conclusion: The present study showed that patients with higher preoperative IPSS scores,higher preoperative bladder residual urine volume(PVR),combined prostatitis,and combined Intravesical prostatic protrusion(IPP)were independent risk factors for insignificant improvement of LUTS after TURP.Insignificant improvement of LUTS after TURP is not caused by a single reason,but by the interaction of multiple factors.Strengthening the intervention to the related risk factors can greatly improve the therapeutic effect of TURP and the postoperative life quality of patients. |
