Testing To Predict Outcome after Transurethral Resection of the Prostate

R. Bruskewitz et al.  Journal of Urology, Vol. 157 1304-1308, April 1997

In a study comparing watchful waiting and TURP, Bruskewitz and colleagues assessed the ability of routine tests to predict outcomes following transurethral resection of the prostrate in the cohort of men randomized to TURP.  800 men were screened to qualify 566 enrollees from which 249 men were randomized to TURP.  Symptom interview, quality of life assessment, uroflowmetry, urinalysis, standard chemistry panel, post-void residual urine determination and cystoscopy, were involved in the pre-procedure analysis as well as the post procedure determination of the predictive value of each of the tests.  Follow-up was semiannual for three years. 

At three years, a determination was made that the largest contrast of data was at a decrease of 7 points of symptom score.  71% of the TURP patients had symptom decreases greater than this point as opposed to 23% for the watchful waiting group.

The conclusion in this study testing predictability is "Symptom analysis and quality of life assessment are most useful in selecting patients for transurethral Resection of the Prostrate.  Objective diagnostic tests are of limited additional benefit."  It was also noted that possibly excessive perioperative intravenous fluids might also be predictive although it was acknowledged that if excess fluids are being used perioperatively, there is probably already a problem.  Although in this study from 1989 objective information is not useful in predicting outcomes, now there might be more to learn from insertion of a temporary prostatic stent like the Spanner which can temporarily deobstruct the patient and potentially demonstrate the outcome of surgical deobstruction.

To read more about this study, See The Journal of Urology, Vol 157 1304-1308, April 1997. Click here

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