Acta Scientific Neurology (ASNE) (ISSN: 2582-1121)

Research Article Volume 4 Issue 9

Can Non-neurological Intrinsic Factors Affect Outcome of TURP in Patients with BPH?

Ganesh Sonawane1, Biju S Pillai2 and H Krishna Moorthy2*

1Senior Resident, Division of Urology, Lourdes Institute of Nephro-Urology, Lourdes Hospital, Kochi, India
2Consultant Urologists, Division of Urology, Lourdes Institute of Nephro-Urology, Lourdes Hospital, Kochi, India

*Corresponding Author: H Krishna Moorthy, Consultant Urologists, Division of Urology, Lourdes Institute of Nephro-Urology, Lourdes Hospital, Kochi, India.

Received: July 25, 2021; Published: August 30, 2021


Introduction: Transurethral resection of prostate (TURP) is the mainstay of surgery for Benign Prostatic Hyperplasia (BPH). However it is estimated that upto 20% of patients have unfavourable results after TURP, suggesting certain other factors affecting outcome of TURP. Neurological changes occurring in the urinary bladder in patients with long standing BPH have been widely postulated as the reason for this poor outcome in some patients. This study was undertaken to assess the role of various intrinsic factors other than neurological causes, influencing outcome of TURP for BPH.

Materials and Methods: This was a prospective study on 120 cases of BPH qualifying inclusion criteria with absolute indications for TURP. Detailed physical, sonological and biochemical evaluation were done pre and post (1 and 3 months) TURP. The results of surgery were compared in various groups to evaluate the role of intrinsic factors like age of patients, prostate size, UTI, catheterization status, grades of diverticula, presence of diverticula and post void residue (PVR) in the outcome of TURP.

Results: There was significant difference in symptom score and flow patterns in pre and post operative patients classified into different groups according to the age, presence of UTI and PVR volume. The post operative flow rates were significantly lower in grade III trabeculation patients compared to other groups. The post operative symptom score was significantly lower and flow rates were higher in the group without diverticula.

Conclusions: Elderly patients (>65years) and patients without UTI before TURP had better functional outcome after TURP. Larger glands (>45grams) had favourable outcome, while poorer outcome was found in patients with higher grades of bladder trabeculations. However, there was no difference in outcome between catheterised and non-catheterised patients. Therefore there is significant role of non-neurological factors in the outcome of TURP for BPH.

Keywords: Benign Prostatic Hyperplasia; Trans Urethral Resection of Prostate; Urodynamics; International Prostate Symptom Score


  1. Arrighi HM., et al. “Natural history of benign prostatic hyperplasia and risk of prostatectomy: the Baltimore longitudinal study of aging”. Urology 1 (1991): 4-8.
  2. Briganti A., et al. “Benign prostatic hyperplasia and its aetiologies”. European Urology13 (2009): 865-871.
  3. De Reijke TM and Klarskov P. “Comparative efficacy of two α1‐adrenoreceptor antagonists, doxazosin and alfuzosin, in patients with lower urinary tract symptoms from benign prostatic enlargement”. BJU International6 (2004): 757-762.
  4. Lodh B., et al. “Digital rectal grading of benign prostatic hyperplasia: Where does it stand today?” Journal of Mahatma Gandhi Institute of Medical Sciences1 (2016): 40.
  5. Gürbüz C and Drake MJ. “Where can urodynamic testing help assess male lower urinary tract symptoms?” Turkish Journal of Urology3 (2019): 157-163.
  6. El-Zawahry A., et al. “The Use of Urodynamics Assessment Before the Surgical Treatment of BPH”. Current Urology Report10 (2016): 73.
  7. Clement KD., et al. “Invasive urodynamic studies for the management of lower urinary tract symptoms (LUTS) in men with voiding dysfunction”. Cochrane Database of Systematic Reviews 4 (2015): CD011179.
  8. Drake MJ., et al. “Diagnostic Assessment of Lower Urinary Tract Symptoms in Men Considering Prostate Surgery: A Noninferiority Randomised Controlled Trial of Urodynamics in 26 Hospitals”. European Urology 5 (2020): 701-710.
  9. Kaplan SA., et al. “Differential diagnosis of prostatism: a 12-year retrospective analysis of symptoms, urodynamics and satisfaction with therapy”. Journal of Urology 155 (1996): 1305-1310.
  10. Hakenberg OW., et al. “The follow-up of patients with unfavourable early results of transurethral prostatectomy”. British Journal of Urology 84 (1999): 799-804.
  11. Milonas D., et al. “The effect of complete transurethral resection of the prostate on symptoms, quality of life, and voiding function improvement”. Central European Journal of Urology 68 (2015): 169-174.
  12. Hakenberg OW., et al. “Preoperative urodynamic and symptom evaluation of patients undergoing transurethral prostatectomy: analysis of variables relevant for outcome”. BJU International 91 (2003): 375-379.
  13. Hossain MA., et al. “Effects of Transurethral Resection of Prostate (TURP) on Quality of Life in Case of Benign Prostatic Hyperplasia”. JNINB 2 (2019): 143-147.
  14. Aldamanhori R and Chapple CR. “Underactive bladder, detrusor underactivity, definition, symptoms, epidemiology, etiopathogenesis, and risk factors”. Current Opinion in Urology 3 (2017): 293-299.
  15. Jeong SJ., et al. “Prevalence and clinical features of detrusor underactivity among elderly with lower urinary tract symptoms: a comparison between men and women”. Korean Journal of Urology5 (2012): 342-348.
  16. Benjamin M., et al. “Factors affecting change in quality of life after prostatectomy: The impact of surgical techniques”. Journal of Urology 155 (1996): 191-196.
  17. Javle P., et al. “Grading of benign prostatic obstruction can predict the outcome of Transurethral Prostatectomy”. Journal of Urology5 (1998): 1713-1717.
  18. Jensen KM., et al. “Urodynamics in prostatism. Prognostic values of medium fill water cystometry”. Scandinavian Journal of Urology and Nephrology 114 (1988): 78-83.
  19. Hakenberg OW., et al. “Does evaluation with the International prostate symptom score predict the outcome of transurethral resection of prostate?” Journal of Urology 158 (1997): 94-99.


Citation: H Krishna Moorthy., et al.“Can Non-neurological Intrinsic Factors Affect Outcome of TURP in Patients with BPH?". Acta Scientific Neurology 4.9 (2021): 77-85.


Copyright: © 2021 H Krishna Moorthy., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Acceptance rate32%
Acceptance to publication20-30 days

Indexed In

News and Events

  • Certification for Review
    Acta Scientific certifies the Editors/reviewers for their review done towards the assigned articles of the respective journals.
  • Submission Timeline for Upcoming Issue
    The last date for submission of articles for regular Issues is May 30, 2024.
  • Publication Certificate
    Authors will be issued a "Publication Certificate" as a mark of appreciation for publishing their work.
  • Best Article of the Issue
    The Editors will elect one Best Article after each issue release. The authors of this article will be provided with a certificate of "Best Article of the Issue"
  • Welcoming Article Submission
    Acta Scientific delightfully welcomes active researchers for submission of articles towards the upcoming issue of respective journals.

Contact US