[Combined transurethral procedure for bladder outlet obstruction induced by small-volume prostatic hyperplasia].

OBJECTIVE

To investigate the clinical effect of transurethral resection of the prostate(TURP) combined with transurethral incision of the bladder neck( TUIBN) in the treatment of bladder outlet obstruction( BOO) caused by small-volume benign prostatic hyperplasia( BPH).

METHODS

We retrospectively analyzed the clinical data about 56 cases of small-volume BPH. The patients,aged 45- 71( mean 59. 6) years,all showed varied degrees of dysuria and 20 of them had a history of chronic prostatitis. Preoperative examinations included the obtainment of International Prostate Symptom Score( IPSS),evaluation of the quality of life(QOL),ultrasonography, urodynamic examination, and cystoscopy. All the patients received alpha-blockers for 3- 6 months without obvious response and therefore underwent TURP + TUIBN.

RESULTS

Postoperative follow-up lasted 12- 24 months. Urinary tract stricture was found in 2 cases(3. 57%) at 1 month after surgery, which was improved after urethral dilation,and bladder neck contracture occurred in 1 case(1. 79%) at 3 months, which was relieved by repeated TUIBN. Compared with the baseline, the IPSS was dramatically decreased at 12 months postoperatively(25. 54 ± 2. 33 vs 12. 76 ± 2. 37,P < 0. 01),and so was the postvoid residual([68. 07 ± 17. 09]vs [31. 02 ± 9. 75] ml. P < 0. 01),while the maximum urinary flow rate(Qmax) was significantly increased([8. 47 ± 0. 96]vs [15. 83 ± 1. 47]ml/s, P < 0. 01).

CONCLUSION

TURP + TUIBN is superior to either TURP or TUIBN alone in the treatment of BOO induced by small-volume BPH for its higher effectiveness and safety.