Correlation between Volume Reduction Ratio and Surgical Complications for Benign Prostatic Hyperplasia after Transurethral Resection of Prostate

Abstract

Background and Purpose: To assess the correlation of volume reduction ratio with the incidence of bladder neck contracture (BNC), erectile dysfunction (ED) and retrograde ejaculation in patients with benign prostatic hyperplasia (BPH) after transurethral resection of prostate (TURP). Methods: From August 1998 to November 2003, 98 men (mean age 70.0 years, range 53-85) with symptomatic BPH were randomly included for evaluation. Transrectal ultrasonography (TRUS) was done before and 12 months after TURP. The prostate volume was estimated by transrectal stepwise planimetric ultrasonography. The volume reduction ratio (VR, %) was calculated as the prostate volume 12 months after TURP divided by that before TURP. BNC was confirmed by cystoscopy, while ED and retrograde ejaculation were verified during follow up. Results: Of 98 patients, 13 (13.3%) had BNC and 60 (61.2%) had retrograde ejaculation after TURP. Of 75 subjects who did not have ED before operation, 7 (9.3%) had ED after surgery. Patients who had BNC or ED after TURP had significantly higher VR than those without (84.6±15.6% vs 74.7±14.2% for BNC, and 82.3±9.3% vs 72.8±14.4% for ED, respectively, p＜0.01), but significantly lower VR was found for patients who had retrograde ejaculation after TURP than those without (73.9±15.8% vs 85.4±20.9%, p＜0.01). Patients who developed BNC postoperatively had less weight of surgical specimen than those who did not have. Conclusion: The volume reduction raio of prostate after TURP may be associated with the incidence of surgical complications after TURP such as BNC, ED and retrograde ejaculation.