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Testing to predict outcome after transurethral resection of the prostate
R C Bruskewitz1, D J Reda, J H Wasson
1Department of Surgery, William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin, USA.
Purpose:
We assessed the ability of routine clinical tests to predict outcome following transurethral resection of the prostate.
Materials And Methods:
A total of 556 men randomized into a trial of surgery versus watchful waiting was evaluated preoperatively with symptom interview, quality of life assessment, uroflowmetry, urinalysis, standard chemistry panel, post-void residual urine determination and cystoscopy. The ability to predict avoidance of postoperative complications, and improvement in quality of life and genitourinary symptoms was assessed in the 249 men randomized to undergo transurethral resection of the prostate.
Results:
Patients with the highest symptom scores were most likely to have symptom improvement and those most bothered by the symptoms were most likely to have improvement in quality of life. No objective tests measuring physiological parameters made clinically significant contributions toward predicting these outcomes. Lower obstructive symptom scores and larger perioperative infusions of intravenous fluids were associated with a greater chance of complications.
Conclusions:
Symptom analysis and quality of life assessment are most useful in selecting patients for transurethral resection of the prostate. Objective diagnostic tests are of limited additional benefit.