Main Article Content
TURP, benign prostatic hypertrophy, elective follow up
Clarify the role of IPSS questionnaire for post TURP operation patients, to assess and streamline best follow-up protocols
Materials and Methods
We identified 87 consecutive patients over 6 months undergoing standardized bipolar TURP. We retro-spectively reviewed patients at 3 months in follow-up clinic, where we performed tests including Qmax, Post-void residual (PVR) and IPSS (International Prostate Symptom Score). We identified patients who were discharged or underwent a change in standard management at this point, and used ROC (Receiver Operating Curve) curve analysis to identify the tools which showed the best ability to predict this decision. Results
ROC curve analysis suggested Qmax (AUC: 0.7751) and IPSS (AUC 0.8571) were the best tools to predict a change in management. Given the IPSS tool is a questionnaire, thus holding most promise to streamline protocols, we applied Youden-J test to show IPSS=8 cut-off was best to identify management changes.
The IPSS tool is able to predict a need for change in management in post TURP patients at 3 months. This will allow a simple triage system to provide an efficient and effective decision-making process for discharge without the need for clinic attendance.
2. Gravas S et al EAU update march 2015. Management of Non-Neurogenic Male Lower Urinary Tract Symptoms (LUTS). EAU Guidelines. Available at: https://uroweb.org/ wp-content/uploads/EAU-Guidelines-Non-Neurogenic-Male-LUTS-Guidelines-2015-v2.pdf.
3. Reich O, et al. Techniques and long-term results of surgical procedures for BPH. Eur Urol 2006 Jun;49(6):970–8; discussion 978. Epub 2006 Feb6. Available at: https:// www.ncbi.nlm.nih.gov/pubmed/16481092.
4. Omar et al MI. Systematic review and meta-analysis of the clinical effectiveness of bipolar compared with monopolar transurethral resection of the prostate (TURP). BJU Int 2014 Jan;113(1):24-35. doi: 10.1111/ bju.12281. Epub 2013 Oct 24. https://www.ncbi.nlm .nih.gov/pubmed/24053602.
5. Devlin NJ.‘Getting the most out of PROMS’. The Kings Fund. Available at: https://www.kingsfund.org.uk/sites/ default/files/Getting-the-most-out-of-PROMs-Nancy-Devlin-John-Appleby-Kings-Fund-March-2010.pdf.