Review of IPSS Questionnaire in Postoperative Transurethral Resection of Prostate (TURP) for Streamlining Follow-up Protocols

Abstract

Objective
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.

Conclusion
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.