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Outcome of transurethral prostatectomy for the palliative management of lower urinary tract symptoms in men with prostate cancer
Author(s) -
GNANAPRAGASAM VINCENT J,
KUMAR VINOD,
LANGTON DAVID,
PICKARD ROBERT S,
LEUNG HING Y
Publication year - 2006
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/j.1442-2042.2006.01391.x
Subject(s) - medicine , lower urinary tract symptoms , prostate cancer , urology , prostatectomy , context (archaeology) , cohort , transurethral resection of the prostate , urinary incontinence , cancer , prostate , gynecology , paleontology , biology
Objective: To investigate the efficacy of palliative transurethral prostatectomy (TURP) for lower urinary tract symptoms (LUTS) in men with prostate cancer. Patients and method: The surgical outcome of TURP performed in 46 men with prostate cancer was studied. A poor outcome was defined as the development of urinary incontinence, repeat surgery and placement of a long‐term catheter (LTC) within 1 year of surgery. A cohort of 47 men who underwent TURP for benign prostatic hyperplasia (BPH) was used as a control population. Results: Initial catheter removal failed in a larger number of cancer patients compared to men with BPH (43% and 10%, respectively, P = 0.0001). Using objective endpoints, 37% (17/46) of cancer patients were defined as having a poor outcome because of repeat surgery, placement of a LTC or urinary incontinence following TURP. These events occurred in only 12% (6/47) of the control cohort ( P = 0.004). In multiple regression analysis a good outcome was associated with presentation in acute urinary retention (AUR; P = 0.01) while a poor outcome was associated with surgery in the context of hormone refractory disease ( P = 0.004). Requirement for a LTC despite surgery (12/46) was also associated with the absence of AUR at presentation ( P = 0.01) and hormone refractory disease ( P = 0.01). Conclusion: A significant number of men with prostate cancer and LUTS may not derive a good palliative benefit from TURP. Patients with hormone refractory disease in particular are more likely to have poorer outcomes.