Defining and discriminating responders from non-responders following transurethral resection of the prostate

Transurethral resection of the prostate (TURP) is the reference standard surgical treatment for lower urinary tract symptoms (LUTS) related to benign prostatic enlargement. The aim of this study was to investigate the response rate following TURP in two distinctly different patient categories; men with bothersome LUTS and men in urinary retention (UR) requiring catheterisation.

In total, 355 men underwent TURP due to LUTS or UR. Responders in the LUTS group were defined as having an International Prostate Symptom Score ≤7 or >50% loss compared to baseline, a Q_max ≥ 15 mL/s or >50% gain compared to baseline, a post-void residual ≤100 mL or a bother score ≤2. Patients fulfilling at least one out of the four criteria were defined as responders. In the UR group, responders were defined as being catheter-free at follow-up.

In total, 337 men remained for final analysis. The proportion operated on due to UR was 46%. In men with LUTS, the response rate was 95%. One in four were classified as excellent responders, fulfilling all four outcome criteria. Men with UR had a successful removal of the catheter after TURP prior to discharge in 77% of the cases and an additional 6% within 3 months, yielding a total response rate of 83%.

TURP is a successful procedure in men with bothersome LUTS and in men with UR. Considering the difference regarding voiding outcomes in men operated on due to LUTS or UR, these groups should be analysed separately in future studies comparing TURP against newer treatment modalities.