Effect of Diabetes Mellitus on Symptomatic Improvement After Surgery for Benign Prostatic Hyperplasia in Patients With Lower Urinary Tract Symptom and its Relations With Prostatic Urethral Angulation.

IF 1.8 3区医学 Q3 UROLOGY & NEPHROLOGY International Neurourology Journal Pub Date : 2023-06-01 DOI:10.5213/inj.2346008.004

Jung Ki Jo, Hwanik Kim, Woo Jin Bang, Cheol Young Oh, Jin Seon Cho, Myungsun Shim

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引用次数: 1

Abstract

Purpose: To compare improvement of lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia in diabetic versus nondiabetic patients after transurethral resection of the prostate (TURP) or holmium laser enucleation of the prostate (HoLEP).

Methods: The medical records of 437 patients who underwent TURP or HoLEP at a tertiary referral center from January 2006 to January 2022 were retrospectively analyzed. Among them, 71 patients had type 2 diabetes. Patients in the diabetic mellitus (DM) and non-DM groups were matched 1:1 according to age, baseline International Prostate Symptom Score (IPSS), and ultrasound measured prostate volume. Changes in LUTS were assessed at 3 months after surgery using IPSS and evaluated by categorizing patients according to prostatic urethral angulation (PUA; <50° vs. ≥50°). Medication-free survival after surgery was also investigated.

Results: No significant differences were noted between the DM and non-DM groups in baseline characteristics except for comorbidities (i.e., hypertension, cerebrovascular disease, and ischemic heart disease, P=0.021, P=0.002, and P=0.017, respectively) and postvoid residual urine volume (115±98 mL vs. 76±105 mL, P=0.028). Non-DM patients showed significant symptomatic improvement regardless of PUA, while DM patients demonstrated improvement in obstructive symptoms only in those with large PUA (≥51°). Among patients with small PUA, DM patients had worse medication-free survival after surgery compared to controls (P=0.044) and DM was an independent predictor of medication reuse (hazard ratio, 1.422; 95% confidence interval, 1.285-2.373; P=0.038).

Conclusion: DM patients experienced symptomatic improvement after surgery only in those with large PUA. Among patients with small PUA, DM patients were more likely to reuse medication after surgery.

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糖尿病对下尿路良性前列腺增生患者术后症状改善的影响及其与前列腺尿道成角的关系

目的:比较糖尿病患者与非糖尿病患者经尿道前列腺切除术(TURP)或钬激光前列腺切除术(HoLEP)后因良性前列腺增生引起的下尿路症状(LUTS)的改善情况。方法:回顾性分析2006年1月至2022年1月在某三级转诊中心行TURP或HoLEP的437例患者的病历。其中71名患者患有2型糖尿病。根据年龄、基线国际前列腺症状评分(IPSS)和超声测量的前列腺体积，将糖尿病(DM)组和非DM组患者进行1:1匹配。术后3个月应用IPSS评估LUTS的变化，并根据前列腺尿道成角(PUA)对患者进行分类;结果:除了合并症(高血压、脑血管疾病和缺血性心脏病，分别P=0.021、P=0.002和P=0.017)和空后残余尿量(115±98 mL vs 76±105 mL, P=0.028)外，DM组和非DM组的基线特征无显著差异。无论PUA大小，非糖尿病患者均表现出明显的症状改善，而DM患者仅在PUA大(≥51°)的患者中表现出阻塞性症状的改善。在PUA较小的患者中，DM患者术后无药生存期较对照组差(P=0.044)， DM是药物重复使用的独立预测因子(风险比，1.422;95%置信区间为1.285-2.373;P = 0.038)。结论:仅PUA较大的DM患者术后症状改善。在PUA较小的患者中，DM患者术后更容易重复用药。

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来源期刊

International Neurourology Journal UROLOGY & NEPHROLOGY-

CiteScore

4.40

自引率

21.70%

发文量

审稿时长

4 weeks

期刊介绍： The International Neurourology Journal (Int Neurourol J, INJ) is a quarterly international journal that publishes high-quality research papers that provide the most significant and promising achievements in the fields of clinical neurourology and fundamental science. Specifically, fundamental science includes the most influential research papers from all fields of science and technology, revolutionizing what physicians and researchers practicing the art of neurourology worldwide know. Thus, we welcome valuable basic research articles to introduce cutting-edge translational research of fundamental sciences to clinical neurourology. In the editorials, urologists will present their perspectives on these articles. The original mission statement of the INJ was published on October 12, 1997. INJ provides authors a fast review of their work and makes a decision in an average of three to four weeks of receiving submissions. If accepted, articles are posted online in fully citable form. Supplementary issues will be published interim to quarterlies, as necessary, to fully allow berth to accept and publish relevant articles.