World J Mens Health.  2015 Dec;33(3):182-187. 10.5534/wjmh.2015.33.3.182.

Preoperative Urinary Retention Increased the Risk of Urinary Retention after Photoselective Vaporization of the Prostate

• Cho SY
• Ro YK
• Kim H
• Son H

• KMID: 2405146
• DOI: http://doi.org/10.5534/wjmh.2015.33.3.182

Abstract

PURPOSE
The aim of the present study was to evaluate preoperative acute urinary retention (AUR) as a factor affecting the outcomes of patients who underwent photoselective vaporization of the prostate (PVP), both in terms of overall effectiveness and the postoperative incidence of AUR.
MATERIALS AND METHODS
Baseline prostate characteristics were obtained for patients who underwent PVP, including prostate-specific antigen (PSA) levels, transrectal ultrasound findings, voiding diary parameters, the International Prostate Symptoms Score (IPSS), and uroflowmetry parameters. These parameters were assessed two weeks, one month, three months, six months, and three years postoperatively. Subjects were divided into AUR and non-AUR groups based on the preoperative occurrence of AUR.
RESULTS
Of the 476 patients, 91 had at least one episode of preoperative AUR. The AUR group was found to be significantly older and to have significantly higher PSA levels, lower body mass indices, and larger prostates. At one year of follow-up, the total IPSS was 7.6+/-6.8 in the AUR group and 11.4+/-8.2 in the non-AUR group, with the AUR group showing a more significant improvement. In the non-AUR group, 17 of the 385 patients (4.4%) experienced postoperative retention, compared to 16 of the 91 patients (17.6%) patients in the AUR group.
CONCLUSIONS
Almost all patients exhibited improvements in subjective and objective voiding parameters following PVP, regardless of the presence of preoperative urinary retention. Patients with a preoperative history of AUR had a higher risk of postoperative retention.

Keyword

Laser therapy; Lower urinary tract symptoms; Prostate; Urinary retention

MeSH Terms

Follow-Up Studies
Humans
Incidence
Laser Therapy
Lower Urinary Tract Symptoms
Prostate*
Prostate-Specific Antigen
Ultrasonography
Urinary Retention*
Volatilization*
Prostate-Specific Antigen

Figure

• 

  Fig. 1 Changes in International Prostate Symptom Scores (IPSS). (A) Total scores, reflecting all symptoms. (B) Subscores reflecting voiding symptoms. (C) Subscores reflecting storage symptoms. (D) Quality of life scores. NUR: no urinary retention, AUR: acute urinary retention, Preop: preoperative.

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