Factors associated with continuing medical therapy after transurethral resection of prostate.

Abstract

OBJECTIVE: To report the clinical characteristics of patients who have persistent

lower urinary tract symptoms (LUTS) after surgery for benign prostatic

hyperplasia (BPH) and continue their medical therapy postoperatively. MATERIALS

AND METHODS: We retrospectively studied 372 patients who underwent transurethral

resection of prostate for LUTS/BPH in 8 institutions to determine the differences

between patients who continued LUTS/BPH medications for >3 months after surgery

and those who did not. Preoperative, intraoperative, and postoperative clinical

parameters were assessed. The Student t test and chi square test were used to

compare each parameter between patient groups. Multivariate logistic regression

analysis was performed to identify risk factors for persistent LUTS and

continuing medical therapy after surgery. RESULTS: There were 205 patients

(55.1%) who continued their LUTS/BPH medications for >3 months postoperatively.

They reported poorer International Prostate Symptom Scores and uroflowmetry

results after surgery. Multivariate analysis showed that age >70 years (odds

ratio [OR], 2.474; P = .001), history of diabetes (OR, 1.949; P = .040), history

of cerebrovascular accident (OR, 5.932; P = .001), any previous LUTS/BPH

medication use (OR, 5.384; P = <0.001), and previous antimuscarinic drug use (OR,

2.962; P = .016) were significantly associated with symptom persistency and

continuing medical therapy. CONCLUSION: Many patients have persistent voiding

dysfunction after surgical treatment for LUTS/BPH. Older age, history of

diabetes, history of cerebrovascular accidents, and preoperative antimuscarinic

drug uses are possible risk factors.