Sestre Milosrdnice University hospital and Institute of Clinical Medical Research
Abstract
Long term efficacy of transurethral incision of the prostate (TUIP) was evaluated in selected patients. A total of 50 patients with symptoms of bladder outlet obstruction caused by smaller benign prostates (estimated weight 30 g or less) were assigned to TUIP. Bilateral incision at "5 and 7" o\u27clock position was performed in all patients. Preoperative and postoperative evaluation included total urinary symptom score (I-PSS), uroflowmetry, patient overall assessment of surgery outcome, and sexual function questionnaire. The mean follow-up time was 66 months (6 to 108 months). Improvements in the mean urinary peak flow rates were observed in all cases. Postoperative total as well as irritation and obstructive symptom scores decreased significantly. All of 28 patients who had been sexually active before surgery retained their sexual activity after surgery, and only one (3.6%) of these had retrograde ejaculation. In comparison to other studies, where patients with bladder outlet obstruction caused by small prostate underwent classic transurethral resection of prostate (TURP), TUIP appeared to be faster, technically easier, and associated with lower morbidity. The results of this study clearly demonstrated TUIP to be an effective treatment for bladder outlet obstruction caused by small prostates in all patients, especially younger men, those with normal sexual activity, and patients at high operative risk. The method showed comparably good long term outcome as TURP, but with less complications.U radu su procijenjeni rezultati transuretralne incizije prostate (TUIP) na duži rok kod selekcioniranih bolesnika. Kod 50 bolesnika sa simptomima subvezikalne opstrukcije, koji su bili uzrokovani malom benignom prostatom (procijenjena težina 30 grama ili manja) učinjen je TUIP. Kod svih bolesnika učinjene su bileteralne incizije na .5 i 7. sati. Prijeoperacijska i poslijeoperacijska procjena kroz intervale praćenja obuhvaćala je ukupnu ocjenu težine simptoma (I-PSS), mikciometriju, ocjenu zadovoljstva bolesnika rezultatom operacijskog zahvata, te upitnik o seksualnim funkcijama. Poboljšanje srednjih vrijednosti maksimalne brzine protoka bilo je vidljivo u svih bolesnika. Poslijeoperacijski ukupni, iritativni i opstruktivni zbroj simptoma pao je značajno u svim razdobljima praćenja. Kod svih 28 bolesnika koji su prijeoperacijski bili seksualno aktivni potencija je sačuvana poslijeoperacijski, a samo je jedan bolesnik signalizirao retrogradnu ejakulaciju. Rezultati ispitivanja uspoređeni su s rezultatima studija transuretralne resekcije (TURP) malih prostata objavljenim u dostupnoj literaturi. TUIP je učinkovita metoda liječenja male benigne prostate, poglavito u mlađih, seksualno aktivnih te visokorizičnih bolesnika, s podjednako dobrim rezultatima na duži rok kao kod TURP-a, ali s puno manje komplikacija
