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A Preoperative Noninvasive Index Prediction Model for TURP Surgical Outcomes in Patients with Benign Prostatic
Jiyao Yang1, Hongjin Shi2, Hui Zhan2
1Department of Urology, Dehong Hospital Affiliated of Kunming Medical University (Dehong Prefecture People's Hospital), Mangshi, China.
Background:
To investigate the influence of preoperative noninvasive indexes on surgical outcomes of benign prostatic hyperplasia (BPH) patients and to establish a clinical prediction model.
Methods:
A total of 250 BPH patients treated with transurethral resection of the prostate (TURP) in our center from December 2020 to June 2023 were included. The evaluation was completed by detailed history questionnaire, an international prostate symptom score (IPSS) assessment, and a urological ultrasonography.
Results:
Among included patients, 185 had effective outcomes, and 65 had ineffective outcomes, with an effective rate of 74%. Univariate and multivariate analyses identified IPSS-voiding/storage (IPSS-V/S) ratio, postvoid residual urine ratio (PVR-R), disease duration, intravesical prostatic protrusion (IPP), history of diabetes, history of urinary retention as independent predictive factors of surgical outcomes, which were further subjected to construct the prediction model. The receiver operating characteristic curve indicated an area under the curve of 0.894. The sensitivity and specificity of the model were 79.46% and 87.69%, respectively. Internal validation and the calibration curve indicated good agreement between the predicted and actual outcomes. Clinical decision curves found that the model had a more significant net clinical benefit than the "all-intervention" and "no-intervention" scenarios.
Conclusion:
The results suggested that BPH patients with a shorter disease duration, a larger IPSS-V/S, a larger IPP, a smaller PVR-R, and no history of diabetes or urinary retention were more likely to have a better outcome after TURP.
