Predictors of storage lower urinary tract symptoms after bipolar transurethral resection of the prostate

Abstract

Background: Storage lower urinary tract symptoms (LUTS) are often experienced after transurethral resection of the prostate (TURP). The purpose of this study was to determine potential risk factors that could contribute to this condition. Methods: This prospective study included 120 consecutive patients undergoing bipolar TURP. Patients undergoing other procedures besides TURP, such as cystolitholapaxy, diverticulectomy, and urethrotomy were excluded, as were patients with neurological diseases or active urinary tract infection (UTI). The standard preoperative evaluation was done routinely, including the International Prostate Symptom Score (IPSS) with its storage and voiding sub-scores, urine culture, and abdominopelvic ultrasonography with an assessment of postvoiding residual urine (PVRU). Possible preoperative, intraoperative, and postoperative variables that may lead to storage LUTS following bipolar TURP were recorded and analyzed. Results: Of 120 patients included in our study, 52 (43.3%) patients experienced storage LUTS at 1 week after catheter removal following bipolar TURP. Of the tested variables, age (68.5 ± 6.0 vs 63.7 ± 5.4 years), higher preoperative irritative IPSS subscore (11.0 ± 2.3 vs 8.0 ± 2.7), smaller prostate size (55.3 ± 12.7 vs 61.0 ± 16.3 gm), gross vs fine hemostasis of prostatic fossa, shorter catheter duration (2.3 ± 0.8 vs 3.0 ± 0.9 days), and post-TURP UTI were found to be statistically significant in univariate analysis. Using backward multivariate logistic regression, after adjustment of significant factors in univariate analysis, it was shown that IPSS irritative subscore was an independent factor affecting storage LUTS post-TURP (OR = 1.525; CI 1.298–1.79, P < 0.001). Conclusions: Variable prognostic factors were related to storage LUTS following TURP; however, preoperative IPSS irritative subscore was an independent factor associated with such a condition, which should be emphasized during preoperative patient counseling.