The Influence of Prostatic Calcification and Lymphocyte Infiltration on the Result of TURP in Patients with Benign Prostatic Hyperplasia

Kim, Sun Gook; Han, Won Chol; Jeong, Hee Jong; Rim, Joung Sik

Abstract

PURPOSE: A transurethral resection of the prostate (TURP) is the gold standard surgical treatment for men with benign prostate hyperplasia (BPH), but 10% of patients shows no improvement in voiding symptom following the procedure. We attempted to find if the prostatic calcification and inflammatory cell infiltration could affect the result of TURP in BPH.
MATERIALS AND METHODS
117 BPH patients who had undergone a TURP, performed by one urologist between March 1999 and February 2001, were evaluated. The prostatic volume, and the size and location of the prostatic calcifications were checked preoperatively. When the calcifications were located around the verumontanum or periurethral area they were classified as central, whereas, when they were located peripherally they were classified as peripheral. The IPSS, Qmax and residual urine were measured preoperatively, and at 6 months after the TURP. The tissues obtained from the TURP were evaluated histologically. Slides of the hematoxylin and eosin-stained tissue of each patient were examined from 5 to 15 chips with a light microscope. They were divided into three groups depending on the level of lymphocyte infiltration; mild: <100/mm2, moderate: 100-499/mm2 and severe: gt;or=500/mm2.
RESULTS
In all groups, there were significant pre- and post-operative differences in the IPSS, Qmax and residual urine (p<0.05, t-test). The prostate weights were significantly decreased in the 'central' group preoperatively, and the Qmax was decreased in the 'central' group 6 months postoperatively (p<0.05, ANOVA).
CONCLUSIONS
We found no influence of prostatic lymphocyte infiltration on the outcome of TURP. Although the preoperative prostate weight of the 'central' group was smaller than in the 'peripheral' group, if the prostatic calcifications were located around the verumontanum or periurethral area, the Qmax was poorer 6 months postoperatively. Therefore, the evaluation of the size and location of prostatic calcifications from TRUS may be useful in predicting the outcome of TURP.