Predictors of postoperative storage symptoms in male patients with lower urinary tract symptoms: A retrospective analysis of prostate surgery for benign prostatic enlargement

IF 1.5 4区医学 Q3 UROLOGY & NEPHROLOGY LUTS: Lower Urinary Tract Symptoms Pub Date : 2024-04-11 DOI:10.1111/luts.12512

Hiroki Ito, Masato Takanashi, Takeshi Fukazawa, Hiroki Takizawa, Mari Hioki, Risa Shinoki, Takashi Kawahara, Kazuhide Makiyama, Kazuki Kobayashi

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Abstract

Objectives

This study investigated the effects of prostate surgery on storage symptoms in male patients with lower urinary tract symptoms (LUTS) from benign prostatic enlargement (BPE). This study aimed to identify patient characteristics associated with improved, unchanged, and deteriorated post-surgical storage symptoms and to identify the risk factors for non-improvement or deterioration.

Methods

A retrospective analysis of 586 prostate surgeries performed between 2016 and 2022 at Yokosuka Kyosai Hospital was conducted on patients with LUTS and at least one storage symptom preoperatively. Patients with active urinary tract infection, prostate/bladder cancer, urethral strictures, or dementia were excluded. The study enrolled 230 patients and assessed storage symptoms using the International Prostate Symptom Score (IPSS).

Results

Overall, storage symptoms improved, remained unchanged, and deteriorated in 87.0%, 5.7%, and 7.4% of patients, respectively. The patients in the deteriorated group were significantly older, whereas those in the no-change group had smaller prostate volumes. Patient-reported outcome scores (IPSS, IPSS-QoL, and BII) were significantly higher in the improved group. The predictors of non-improvement included low IPSS storage score, cardiovascular disease, and diabetes mellitus. Predictors of deterioration included advanced age and low IPSS storage score.

Conclusions

Patients with severe LUTS showed greater postoperative improvement in storage symptoms. A low IPSS storage score predicted non-improvement and deterioration. Advanced age, low IPSS storage score, and a history of cardiovascular disease and diabetes mellitus were identified as key predictors. Awareness of these factors may guide preoperative counseling and improve decision-making in prostate surgery, ensuring more personalized and effective treatment strategies.

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下尿路症状男性患者术后储尿症状的预测因素：对良性前列腺增生前列腺手术的回顾性分析

目的本研究调查了前列腺手术对良性前列腺增生（BPE）引起的下尿路症状（LUTS）男性患者储尿症状的影响。本研究旨在确定与手术后储尿症状改善、不变和恶化相关的患者特征，并确定未改善或恶化的风险因素。方法对横须贺共济医院在 2016 年至 2022 年期间进行的 586 例前列腺手术进行回顾性分析，研究对象为术前患有 LUTS 并至少有一种贮尿症状的患者。排除了患有活动性尿路感染、前列腺癌/膀胱癌、尿道狭窄或痴呆症的患者。该研究共招募了 230 名患者，并使用国际前列腺症状评分（IPSS）对储尿症状进行了评估。结果总体而言，分别有 87.0%、5.7% 和 7.4% 的患者贮尿症状有所改善、保持不变或恶化。恶化组患者的年龄明显偏大，而无变化组患者的前列腺体积较小。病情好转组的患者报告结果评分（IPSS、IPSS-QoL 和 BII）明显更高。未改善组的预测因素包括 IPSS 存储得分低、心血管疾病和糖尿病。恶化的预测因素包括高龄和 IPSS 存储评分低。结论 LUTS 严重的患者术后储尿症状改善程度更大。IPSS 存储评分低预示症状无改善和恶化。高龄、IPSS 存储评分低、心血管疾病和糖尿病史被认为是主要的预测因素。对这些因素的认识可指导术前咨询并改善前列腺手术的决策，从而确保采取更加个性化和有效的治疗策略。

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来源期刊

LUTS: Lower Urinary Tract Symptoms UROLOGY & NEPHROLOGY-

CiteScore

3.00

自引率

7.70%

发文量

审稿时长

>12 weeks

期刊介绍： LUTS is designed for the timely communication of peer-reviewed studies which provides new clinical and basic science information to physicians and researchers in the field of neurourology, urodynamics and urogynecology. Contributions are reviewed and selected by a group of distinguished referees from around the world, some of whom constitute the journal''s Editorial Board. The journal covers both basic and clinical research on lower urinary tract dysfunctions (LUTD), such as overactive bladder (OAB), detrusor underactivity, benign prostatic hyperplasia (BPH), bladder outlet obstruction (BOO), urinary incontinence, pelvic organ prolapse (POP), painful bladder syndrome (PBS), as well as on other relevant conditions. Case reports are published only if new findings are provided. LUTS is an official journal of the Japanese Continence Society, the Korean Continence Society, and the Taiwanese Continence Society. Submission of papers from all countries are welcome. LUTS has been accepted into Science Citation Index Expanded (SCIE) with a 2011 Impact Factor.