Purpose: To create a prediction model that could preoperatively measure the success of the transurethral prostate resection (TURP) because of bladder outlet obstruction. Methods: Patients aged 50–80 years applied with TURP were examined prospectively and evaluated in respect of the preoperative and postoperative values of maximum flow rate (Qmax), international prostate symptom score (IPSS), quality of life (QoL) score and post-voiding residual (PVR) urine amount. On the preoperative transabdominal ultrasonography, total prostate volume (TPV), and protruding prostate lobe volume (PPLV) were measured and the protruding ratio (PR), as the ratio of PPLV to TPV, was calculated. Based on the mean of the preoperative and postoperative Qmax difference (Qmax-D) value, Group 1 (n = 33) was defined as “low efficacy” and Group 2 (n = 30) as “high efficacy”. Results: A correlation was determined between the QMax-D, IPSS difference, PVR difference, and QoL difference measured for the efficacy of the operation, and TPV, PPLV and PR. The results of multivariate analysis showed the main effect to be created by PR (p = 0.000; OR 1.596). In the evaluation with receiver operating characteristic curve analysis of high efficacy obtained in the TURP, a significantly powerful effect of the measurements of PPLV area under curve (AUC 0.922 [0.855–0.989] p= 0.000) and PR (AUC 0.954 [0.982–1.000] p = 0.000) was determined. The cutoff value of 11.5 was detected for PR. Efficacy sensitivity and the positive predictive values were recorded as 93.3%, and specificity and negative predictive value as 93.9%. Conclusion: When determining candidate patients for TURP surgery, measurements of the PPLV and especially the PR should be taken into consideration in the preoperative prediction of efficacy.

1.
European Association of Urology Guideline, Treatment of Non-neurogenic Male LUTS. (2017). Publishing EAU web. http://uroweb.org/wp-content/uploads/13-Non-Neurogenic-Male-LUTS_2017_web.pdf
2.
Tsukamoto T, Kumamoto Y, Masumori N, Miyake H, Rhodes T, Girman CJ, et al. Prevalence of prostatism in Japanese men in a community-based study with comparison to a similar American study.
J Urol
. 1995 Aug;154(2 Pt 1):391–5.
3.
Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U, et al.; Standardisation Sub-committee of the International Continence Society. The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society.
Neurourol Urodyn
. 2002;21(2):167–78.
4.
Madersbacher S, Marberger M. Is transurethral resection of the prostate still justified?
BJU Int
. 1999 Feb;83(3):227–37.
5.
Ahyai SA, Gilling P, Kaplan SA, Kuntz RM, Madersbacher S, Montorsi F, et al. Meta-analysis of functional outcomes and complications following transurethral procedures for lower urinary tract symptoms resulting from benign prostatic enlargement.
Eur Urol
. 2010 Sep;58(3):384–97.
6.
Oelke M, Bachmann A, Descazeaud A, Emberton M, Gravas S, Michel MC, et al.; European Association of Urology. EAU guidelines on the treatment and follow-up of non-neurogenic male lower urinary tract symptoms including benign prostatic obstruction.
Eur Urol
. 2013 Jul;64(1):118–40.
7.
Huang T, Yu YJ, Qi J, Xu D, Duan LJ, Ding J, et al. Establishment and value assessment of efficacy prediction model about transurethral prostatectomy.
Int J Urol
. 2015 Sep;22(9):854–60.
8.
Seki N, Yunoki T, Tomoda T, Takei M, Yamaguchi A, Naito S. Association among the symptoms, quality of life and urodynamic parameters in patients with improved lower urinary tract symptoms following a transurethral resection of the prostate.
Neurourol Urodyn
. 2008;27(3):222–5.
9.
Chia SJ, Heng CT, Chan SP, Foo KT. Correlation of intravesical prostatic protrusion with bladder outlet obstruction.
BJU Int
. 2003 Mar;91(4):371–4.
10.
Keqin Z, Zhishun X, Jing Z, Haixin W, Dongqing Z, Benkang S. Clinical significance of intravesical prostatic protrusion in patients with benign prostatic enlargement.
Urology
. 2007 Dec;70(6):1096–9.
11.
Fulgham PF, Bishoff JT. Campbell-Walsh Urology, Urinary tract imaging, 10th edition Philadelphia; 2012. p. 122.
12.
Abrams PH, Griffiths DJ. The assessment of prostatic obstruction from urodynamic measurements and from residual urine.
Br J Urol
. 1979 Apr;51(2):129–34.
13.
Van Mastrigt R, Pel JJ. Towards a noninvasive urodynamic diagnosis of infravesical obstruction.
BJU Int
. 1999 Jul;84(2):195–203.
14.
McConnell JD. Why pressure-flow studies should be optional and not mandatory studies for evaluating men with benign prostatic hyperplasia.
Urology
. 1994 Aug;44(2):156–8.
15.
Kojima M, Ochiai A, Naya Y, Ukimura O, Watanabe M, Watanabe H. Correlation of presumed circle area ratio with infravesical obstruction in men with lower urinary tract symptoms.
Urology
. 1997 Oct;50(4):548–55.
16.
Lim KB, Ho H, Foo KT, Wong MY, Fook-Chong S. Comparison of intravesical prostatic protrusion, prostate volume and serum prostatic-specific antigen in the evaluation of bladder outlet obstruction.
Int J Urol
. 2006 Dec;13(12):1509–13.
17.
Wang D, Foo KT. Staging of benign prostate hyperplasia is helpful in patients with lower urinary tract symptoms suggestive of benign prostate hyperplasia.
Ann Acad Med Singapore
. 2010 Oct;39(10):798–802.
18.
Manieri C, Carter SS, Romano G, Trucchi A, Valenti M, Tubaro A. The diagnosis of bladder outlet obstruction in men by ultrasound measurement of bladder wall thickness.
J Urol
. 1998 Mar;159(3):761–5.
19.
Oelke M, Höfner K, Jonas U, de la Rosette JJ, Ubbink DT, Wijkstra H. Diagnostic accuracy of noninvasive tests to evaluate bladder outlet obstruction in men: detrusor wall thickness, uroflowmetry, postvoid residual urine, and prostate volume.
Eur Urol
. 2007 Sep;52(3):827–34.
20.
Kessler TM, Gerber R, Burkhard FC, Studer UE, Danuser H. Ultrasound assessment of detrusor thickness in men-can it predict bladder outlet obstruction and replace pressure flow study?
J Urol
. 2006 Jun;175(6):2170–3.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.