Avaliação clínica e qualidade de vida nas hiperplasias prostáticas benignas

Abstract

Benign prostatic hyperplasia (BPH) is the most common benign tumor in men and its prevalence is related to aging, affecting more than 90% of men over 80 years old. Its treatment aims to reduce clinical complications related to the benign growth of the prostate. Patients with such severe symptoms may undergo bipolar transurethral resection of the prostate (TURP), which is the gold-standard to the surgical approach in BPH. However, many patients may not benefit the most afterwards, overshadowing its clinical improvements. In this study, a multiple regression analysis has been performed in order to try to predict surgical success considering prostate weight pre and post-surgery, the International Prostate Symptom Score (IPSS), and Quality of Life (QoL). There were 90 patients included in the study sample submitted to bipolar TURP, with a mean age of 67,3 years old. Out of them, 60 (66,7%) men had a weight of prostate equal or greater than 50g. That was the greatest find of this study. Regression analysis has shown the feasibility of a new weight cutoff point. It was demonstrated that the cutoff point described in the current literature - greater than 60 g - major, at least in our sample, some patients even after surgery still presented without significant clinical improvement, overshadowing its benefits. Specifically, they have had a IPSS post-surgery mean of 8.2 (±3,6) - with statistical significance, but with the mean greater than the clinical cutoff point as for IPSS, i.e., patients remained clinically ill. It turns out that a new criteria for surgery is a prostate weight above 50g. We have found that patients above the cutoff point of 50g who underwent bipolar TURP had benefited the most. We recommend that it is yet reasonable to follow-up every BPH case, and that there should have more investment upon systematic review and meta-analysis studies to confirm this consensus.