1738 PATIENT WITH SMALL RESECTED PROSTATE WEIGHT IN TRANSURETHRAL RESECTION OF THE PROSTATE IS ASSOCIATED WITH A HIGHER INCIDENCE OF NEUROLOGICAL COMORBIDITIES íV A NATION-WIDE STUDY

Abstract

INTRODUCTION AND OBJECTIVES: Transurethral resection of the prostate (TURP) is a standard procedure for relieving prostate obstruction to improve lower urinary tract symptom (LUTS). However, some patients have persistent LUTS following TURP and we suspect some neurological co-morbidities might contribute to LUTS. We conducted this study to investigate the prevalence of some neurological disorders in patients receiving TURP. METHODS: The subset of the National Health Insurance Research Database (NHIRD) of Taiwan contains data of all medical benefit claims and covers most Taiwan populations. According to ICD codes-9, all patients received TURP from 2006 to 2009, with diagnostic codes, 600.X-602.X. All patients with diagnosis of genitourinary cancer before TURP were excluded. The patients were also excluded if the diagnosis of prostate cancer was recorded in one month after operation. Different benefit claims were submitted to National Health Insurance according to different resected prostate weight. Therefore we could subdivide patients into three groups, small group ( 15 grams), medium group (15 50 grams), large group ( 50 grams). We determined the incidence of neurological diagnostic codes of cerebrovascular event (CVA) (430,431,432.X,433, 434.X,436-438), Parkinsonias disease (332.X), spinal stenosis (724.0X, 723.0), herniation of intervertebral disc (HIVD) (722.0X-722.2X,722.4X-722.7X), which were claimed within one year before TURP. The difference between these three groups was analyzed. RESULTS: Among the total population of 22.8 millions, 33905 patients received TURP for BPH from 2006 to 2009. The patientias number of each subgroups were 14511 (42.8%) in small group, 16487 (48.6%) in medium group, and 2907 (8.6%) in large group. The number of patients with CVA, Parkinson disease, spinal stenosis, and HIVD diagnosed before TURP in each subgroup was shown in the Table 1. The incidence of every neurological disorder is significantly higher in smaller resected weight group than in medium and large group. CONCLUSIONS: This study found that the incidence of neurological comorbidity is significantly higher in patients with smaller weight resected by TURP. It implies that neurological comorbidity significantly contribute to male LUTS.