Investigative and Clinical Urology

The Korean Urological Association (대한비뇨의학회)
권호 표지
DOI QR코드

DOI QR Code

The Functional Effect of Palliative Transurethral Resection of the Prostate on Lower Urinary Tract Symptoms in Patients with Prostate Cancer

하부요로증상을 보인 전립선암 환자에 시행한 고식적 경요도전립선절제술의 배뇨개선효과

Chung, Ho-Suck;Im, Chang-Min;Kim, Sun-Ouck;Jung, Seung-Il;Kwon, Dong-Deuk;Park, Kwang-Sung;Ryu, Soo-Bang
정호석;임창민;김선옥;정승일;권동득;박광성;류수방

  • Published : 20090500
⟨ Previous Next ⟩

Abstract

Purpose: Voiding dysfunction occurs frequently in patients with prostate cancer. We investigated the functional effect of palliative transurethral resection of the prostate (pTURP) on lower urinary tract symptoms in patients with prostate cancer. Materials and Methods: We retrospectively assessed all patients who had a pTURP at our institution between 1999 and 2006. Patients with incidental prostate cancer were excluded. In all, 64 patients were enrolled in the study. The International Prostate Symptom Score (IPSS), the quality of life (QoL), the maximal flow rate (Qmax), and the postvoid residual urine volume (PVR) were evaluated before and after 3 months of pTURP. A positive functional outcome was defined as PVR below 100 ml, no additional catheterization, no repeat pTURP, and no development of urinary incontinence. Results: The patients' mean age was 76.32${\pm}$6.8 years, and their mean prostate volume was 46.38${\pm}$19.43 g. After pTURP, the mean IPSS improved from 25.83${\pm}$6.71 to 18.63${\pm}$5.96, the mean QoL score improved from 4.33${\pm}$ 0.87 to 3.02${\pm}$0.83, the mean maximal flow rate increased from 6.11${\pm}$3.68 ml/sec to 14.20${\pm}$6.30 ml/sec, and the PVR decreased from 153.69${\pm}$32.03 ml to 41.89${\pm}$25.35 ml. All voiding parameters showed significant improvement (p<0.001). Of the 64 patients, 12 had poor functional outcome after pTURP. The functional improvement rate of pTURP was 81.25%. Conclusions: The pTURP performed in patients with prostate cancer showed a favorable effect and resulted in significant improvement in voiding dysfunction. In patients with high-stage metastatic prostate cancer or cancer unsuitable for curative therapy, pTURP could be considered as a safe treatment method to improve lower urinary tract symptoms.

Keywords

References

  1. Jemal A, Siegel R, Ward E, Murray T, Xu J, Thun MJ. Cancer statistics, 2007. CA Cancer J Clin 2007;57:43-66 https://doi.org/10.3322/canjclin.57.1.43
  2. Choe JH, Lee HM, Chai SE, Choi HY. Long-term healthrelated quality of life in patients with prostate cancer after treatment. Korean J Urol 2004;45:878-89
  3. Lee HW, Kwak KW, Choi YH, Choi HY, Lee HM. New thresholds for prostate-specific antigen velocity for prostate cancer screening in Korean patients younger than 60 years old. Korean J Urol 2008;49:113-7 https://doi.org/10.4111/kju.2008.49.2.113
  4. Moul JW, Davis R, Vaccaro JA, Sihelnik SA, Belville WD, McLeod DG. Acute urinary retention associated with prostatic carcinoma. J Urol 1989;141:1375-7 https://doi.org/10.1016/S0022-5347(17)41312-7
  5. Scherr D, Swindle PW, Scardino PT. National Comprehensive Cancer Network guidelines for the management of prostate cancer. Urology 2003;61(2 Suppl 1):14-24 https://doi.org/10.1016/S0090-4295(02)02395-6
  6. Varkarakis J, Bartsch G, Horninger W. Long-term morbidity and mortality of transurethral prostatectomy: a 10-year followup. Prostate 2004;58:248-51 https://doi.org/10.1002/pros.10339
  7. Djavan B, Madersbacher S, Klingler HC, Ghawidel K, Basharkhah A, Hruby S, et al. Outcome analysis of minimally invasive treatments for benign prostatic hyperplasia. Tech Urol 1999;5:12-20
  8. Marszalek M, Ponholzer A, Rauchenwald M, Madersbacher S. Palliative transurethral resection of the prostate: functional outcome and impact on survival. BJU Int 2007;99:56-9 https://doi.org/10.1111/j.1464-410X.2006.06529.x
  9. Gnanapragasam VJ, Kumar V, Langton D, Pickard RS, Leung HY. Outcome of transurethral prostatectomy for the palliative management of lower urinary tract symptoms in men with prostate cancer. Int J Urol 2006;13:711-5 https://doi.org/10.1111/j.1442-2042.2006.01391.x
  10. Crain DS, Amling CL, Kane CJ. Palliative transurethral prostate resection for bladder outlet obstruction in patients with locally advanced prostate cancer. J Urol 2004;171:668-71 https://doi.org/10.1097/01.ju.0000104845.24632.92
  11. Hand JR. Conservative operations for carcinoma of the prostate: analysis of 109 cases. J Urol 1950;64:123-48 https://doi.org/10.1016/S0022-5347(17)68612-9
  12. Chute R, Willetts AT, Gens JP. Experiences in the treatment of carcinoma of the prostate with stilbestrol and with castration by the technique of intra-capsular orchiectomy. J Urol 1942;48:682 https://doi.org/10.1016/S0022-5347(17)70760-4
  13. Fleischmann JD, Catalona WJ. Endocrine therapy for bladder outlet obstruction from carcinoma of the prostate. J Urol 1985;134:498-500 https://doi.org/10.1016/S0022-5347(17)47257-0
  14. Varenhorst E, Alund G. Urethral obstruction secondary to carcinoma of prostate: response to endocrine treatment. Urology 1985;25:354-6 https://doi.org/10.1016/0090-4295(85)90485-6
  15. Carpentier PJ, Schroder FH. Transrectal ultrasonography in the follow up of prostatic carcinoma patients: a new prognostic parameter? J Urol 1984;131:903-5 https://doi.org/10.1016/S0022-5347(17)50705-3
  16. Thomas DJ, Balaji VJ, Coptcoat MJ, Abercrombie GF. Acute urinary retention secondary to carcinoma of the prostate. Is initial channel TURP beneficial? J R Soc Med 1992;85:318-9
  17. Pergament MC, Swaim WR, Blackard CE. Disseminated intravascular coagulation in the urological patient. J Urol 1976;116:1-7 https://doi.org/10.1016/S0022-5347(17)58650-4
  18. Madersbacher S, Marberger M. Is transurethral resection of the prostate still justified? BJU Int 1999;83:227-37 https://doi.org/10.1046/j.1464-410x.1999.00908.x
  19. Crain DS, Amling CL, Kane CJ. Palliative transurethral prostate resection for bladder outlet obstruction in patients with locally advanced prostate cancer. J Urol 2004;171:668-71 https://doi.org/10.1097/01.ju.0000104845.24632.92
  20. Hanks GE, Leibel S, Kramer S. The dissemination of cancer by transurethral resection of locally advanced prostate cancer. J Urol 1983;129:309-11 https://doi.org/10.1016/S0022-5347(17)52069-8
  21. Bandhauer K. The possible role of transurethral resection in the dissemination of prostatic cancer. Eur Urol 1975;1:272-4
  22. Sandler HM, Hanks GE. Analysis of the possibility of that transurethral resection promotes metastasis in prostate cancer. Cancer 1988;62:2622-7 https://doi.org/10.1002/1097-0142(19881215)62:12<2622::AID-CNCR2820621229>3.0.CO;2-W
  23. Pansadoro V, Sternberg CN, DePaula F, Florio A, Giannarelli D, Arcangeli G. Transurethral resection of the prostate and metastatic prostate cancer. Cancer 1991;68:1895-8 https://doi.org/10.1002/1097-0142(19911101)68:9<1895::AID-CNCR2820680908>3.0.CO;2-B
  24. Nativ O, Bergstralh EJ, Boyle ET Jr, Zincke H. Transurethral resection versus needle biopsy prior to radical prostatectomy for stage C prostate cancer. Influence on progression and survival. Urology 1991;37:22-7 https://doi.org/10.1016/0090-4295(91)80071-E
  25. Paul R, Knebel C, van Rondenborgh H, Kubler H, Alschibaja M, Gunther M, et al. Incidental carcinoma of the prostate: can we and should we recommend radical prostatectomy? Urologe A 2005;44:1052, 1054-8
  26. Levine ES, Cisek VJ, Mulvihill MN, Cohen EL. Role of transurethral resection in dissemination of cancer of prostate. Urology 1986;28:179-83 https://doi.org/10.1016/0090-4295(86)90038-5
  27. Paulson DF, Cox EB. Does transurethral resection of the prostate promote metastatic disease? J Urol 1987;138:90-1 https://doi.org/10.1016/S0022-5347(17)43002-3
  28. Meacham RB, Scardino PT, Hoffman GS, Easley JD, Wilbanks JH, Carlton CE Jr. The risk of distant metastases after transurethral resection of the prostate versus needle biopsy in patients with localized prostate cancer. J Urol 1989;142:320-5 https://doi.org/10.1016/S0022-5347(17)38745-1
  29. Mazur AW, Thompson IM. Efficacy and morbidity of channel TURP. Urology 1991;38:526-8 https://doi.org/10.1016/0090-4295(91)80170-C

Cited by

  1. 중년남성의 하부요로증상, 하부요로증상 자가관리 및 삶의 질 vol.21, pp.3, 2010, https://doi.org/10.12799/jkachn.2010.21.3.303