[Prostatic symptoms problems after surgery of benign hyperplasia of the prostate]

To evaluate the impact of surgical therapy for benign prostatic hyperplasia on the problems caused by prostatic symptoms to patients.

122 patients were evaluated with regards to the issues arising from prostatic symptoms through the Symptom Problem Index (SPI) questionnaire. Symptoms intensity (I-PSS questionnaire) and flow data were analyzed. Measurements were performed prior and six months after surgery.

Mean age 68.8 +/- 6.9 SD years. In 46.3% cases a surgical approach was decided upon based only on symptoms. After surgery, I-PSS score improvement was seen in 91.0%, 78% stated they were delighted or very satisfied with their symptoms and 70% showed peak flow improvement. SPI score prior to surgery was 15.9 +/- 6.7 SD and after surgery 4.3 +/- 5.7 SD (p < 0.0001). Worse rated symptoms after surgery are still nycturia, urgency, and pollakiuria; obstructive symptoms were better tolerated than irritative symptoms. Interestingly, there is also greater tolerance of nycturia (p < 0.001) relative to the previous problem. A higher tolerance of prostatic symptoms with surgery correlates with an improvement of scores in irritative symptoms (r = 0.888; p < 0.0001), and even more with improvement of obstructive symptoms (r = 0.925; p < 0.0001). Tolerance increased with improved scores in I-PSS questionnaire (r = 0.644; p = < 0.0001), in patients with previous higher I-PSS (r = 0.333; p < 0.001), worse IQL quality of life (r = 0.215; p < 0.018), and worse previous tolerance to prostatic symptoms (r = 0.690; p < 0.001), in younger patients (r = -0.179; p = 0.05) and in the absence of problems with the development of sexual activity and post-operative complications, basically urinary incontinence.

The problems suffered by patients as a result of symptoms after surgery show greater improvement than the symptoms intensity and is greater in patients with worse pre-operative clinical condition and those previously more concerned with their symptoms. It should be highlighted the lower repercussion from nycturia after the procedure and the fact that irritative symptoms are less well tolerated. On the other hand, the frequent changes in sexual activity caused by this procedure result in symptoms being less well tolerated, as it also happens with the possible existence of post-operative urinary incontinence.