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Dekalo & Welk

Table 1. Pre- and post-TURP PVRs and Qmax
Preoperative Postoperative followup at 4–8 weeks Final postoperative followup
(median 3.5 years)
Qmax (mL/sec) PVR (mL) Qmax (mL/sec) PVR (mL) Qmax (mL/sec) PVR (mL)
All men (n=14) 8 (IQR 6–13) 820 (IQR 691–985) 17 (IQR 7–18)* 143 (IQR 60–430)* 14 (IQR 6–17)* 337 (IQR 5–550)*
Men with UDS confirmed 8.5 (IQR 6–17) 849 (IQR 600–990) 17 (IQR 10–17)* 333 (IQR 40–430)* 15 (IQR 6–16)* 300 (IQR 25–760)*
BOO (n=5)
*p<0.01 compared to preoperative value. BOO: bladder outlet obstruction; IQR: interquartile range; PVR: postvoid residual; Qmax: maximal flow rate; TURP: transurethral resection of the
prostate; UDS: urodynamic study.
toperative Clavien-Dindo complications ≥3, median weight of PVRs, but we believe our data will help the urologist in
prostate tissue removed was 8.3 g (IQR 6.2–11), and duration decision-making and patient counselling when encountering
of postoperative catheterization was <5 days for all men.At this clinical scenario.
the first postoperative followup (4–8 weeks after surgery), the Our study limitations include the small sample size, which
PVR was significantly lower and the Qmax was significantly limited our ability to further analyze subgroups. Our inclu-
higher (Table 1). Patients had a median postoperative followup sion criteria mean that these results are not generalizable
period of 3.5 years (IQR 2–7) and at the patient’s final follo- to all men with a large PVR. Finally, there is no comparison
wup, the PVR continued to be significantly lower compared group, and it is possible that with conservative management,
to the preoperative measurement (Table 1); only one man these men would not have developed any further urinary
had a PVR higher than his preoperative value (by 30 mL). dysfunction over time.
Similar improvements were seen in the men with confirmed
BOO on UDS (Table 1). No one needed to use catheters Conclusions
throughout the followup period and there were no bladder
neck contractures or evidence of upper tract deterioration or In our small cohort of selected men with elevated PVRs and
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obstructive uropathy. mild or no LUTS, TURP improved PVRs and Qmax pos---
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toperatively, and this improvement was maintained during
Discussion a median followup of over three years.
This small pilot study demonstrates that men with mild urin- Competing interests: The authors do not report any competing personal or financial interests
ary symptoms and elevated PVRs experienced numerical related to this work.
improvement in their PVRs and Qmax after TURP, and this
benefit appears to be sustained over a median of three years.
This study supports the concept that first, TURP is safe in This paper has been peer-reviewed.
these patients; and second, that it may prevent deterioration
in bladder function in the future. It is important to note that
this was a carefully selected group of men who participated References
in shared decision-making and were motivated to try and
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318 CUAJ • October 2022 • Volume 16, Issue 10