Incidencia y factores asociados al uso de medicamentos y retratamiento quirúrgico posterior a resección transuretral de próstata

J.A. Herrera-Muñoz, J. Gómez-Sánchez, D.A. Preciado-Estrella, J. Sedano-Basilio, L. Trujillo-Ortiz, I. Uberetagoyena-Tello de Meneses, A. Palmeros-Rodríguez, V. Cornejo-Dávila, G. Fernández-Noyola, M. Cantellano-Orozco, C. Martínez-Arroyo, J.G. Morales-Montor, C. Pacheco-Gahbler
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Abstract

Introduction

Transurethral resection of the prostate (TURP) is a standard procedure for obstructive prostatic growth. Medical retreatment with anticholinergics, alpha-blockers, and 5 alpha reductase inhibitors is from 16 to 50%. A second surgical retreatment is associated with internal urethrotomy, cervicotomy, and re-TURP between 5 and 13% at 5 years. Re-TURP is associated with residual tissue.

Aim

To determine the incidence of and factors associated with the use of medications and surgical retreatment after TURP.

Material and methods

A retrospective study was conducted on patients that underwent TURP within the time frame of January 2010 and December 2011 with follow-up to the present. Preoperative, intraoperative, and postoperative variables were analyzed and the chi-square test was used for the statistical analysis.

Results

Follow-up was carried out on 158 patients that underwent TURP. The overall accumulated incidence of retreatment was 43%, surgical retreatment was 17.7%, and medical treatment was 30.4%. TURP retreatment was 7.6% and transvesical prostatectomy was 1.3%. The mean time until prostate surgery retreatment was 30.5 months. Postoperative medical treatment was: anticholinergics 17.1%, alpha-blockers 15.2%, 5 alpha reductase inhibitors 6.3%, and combination 8.2%. During follow-up, 22.8% of the patients had residual tissue, which was the main cause of retreatment. Preoperative prostatic volume > 80 g was associated with residual tissue (p = 0.024).

Conclusions

In our study, the incidence of surgical retreatment was higher than that reported in the literature, at 17.7% vs. 13%, respectively, and medical treatment was lower at 30.4% vs. 50%, respectively. Anticholinergics were the most utilized medications. Adequate patient selection will reduce complications and risk for retreatment.

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经尿道前列腺切除术后药物使用及手术再治疗的发生率及相关因素
经尿道前列腺切除术(TURP)是治疗梗阻性前列腺生长的标准手术。用抗胆碱能药物、α受体阻滞剂和5 α还原酶抑制剂进行医学治疗的比例为16%至50%。第二次手术再治疗与内尿道切开术、宫颈切开术和5年内5% - 13%的再次turp相关。Re-TURP与残留组织有关。目的了解TURP术后药物及手术再治疗的发生率及相关因素。材料与方法对2010年1月至2011年12月期间行TURP的患者进行回顾性研究,并随访至今。对术前、术中、术后变量进行分析,采用卡方检验进行统计分析。结果对158例行TURP的患者进行了随访。总累计复诊率为43%,手术复诊率为17.7%,内科复诊率为30.4%。经尿道前列腺切除术的复治率为7.6%,经膀胱前列腺切除术的复治率为1.3%。到前列腺手术再治疗的平均时间为30.5个月。术后用药:抗胆碱能药物17.1%,α -受体阻滞剂15.2%,α -还原酶抑制剂6.3%,联合用药8.2%。随访期间,22.8%的患者有组织残留,这是再次治疗的主要原因。术前前列腺体积>80 g与残留组织相关(p = 0.024)。结论在本研究中,手术再治疗的发生率高于文献报道,分别为17.7%和13%,内科治疗的发生率分别为30.4%和50%。抗胆碱能药物是使用最多的药物。适当的患者选择将减少并发症和再治疗的风险。
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来源期刊
Revista mexicana de urologia
Revista mexicana de urologia Medicine-Urology
CiteScore
0.20
自引率
0.00%
发文量
49
期刊介绍: Revista Mexicana de Urología (RMU) [Mexican Journal of Urology] (ISSN: 0185-4542 / ISSN electronic: 2007-4085) is bimonthly publication that disseminates research by academicians and professionals of the international medical community interested in urological subjects, in the format of original articles, clinical cases, review articles brief communications and letters to the editor. Owing to its nature, it is publication with international scope that disseminates contributions in Spanish and English that are rigorously reviewed by peers under the double blind modality. Neither journalistic documents nor those that lack rigorous medical or scientific support are suitable for publication.
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