DOI:10.13263/j.cnki.nja.2013.01.010 35 NJA National Journal of Andrology Zhonghua Nan Ke Xue Za Zhi 2013 19 1 35-39 http / /www. androl. cn Clinical Research TURP / 537100 BPH TURP 2009 5 2011 5 TURP BPH 432 A BPH 30 B 55 C 31 D 28 IPSS 1 399 92. 4% 269 67. 4% 86 21. 6% 44 11. 0% IPSS A 21. 43 ± 6. 09 B 21. 75 ± 5. 97 C 27. 84 ± 4. 18 D 31. 00 ± 2. 92 A B P = 1. 000 P < 0. 01 IPSS A 5. 60 ± 2. 16 B 7. 36 ± 2. 77 C 11. 55 ± 3. 39 D 16. 89 ± 3. 37 P < 0. 01 IPSS P < 0. 01 BPH BPH BPH BPH R697 +. 3 1 A 1009-3591 2013 01-0035-05 LUTS in BPH patients with histological prostatitis before and after transurethral resection of the prostate HUANG Xiang-hua QIN Bin LIANG Yi-wen WU Qing-guo LI Chang-zan WEI Gang-shan JI Han-chu LIANG Yang-bing CHEN Hong-qiu GUAN Ting Department of Urology The Eighth Hospital Affiliated to Guangxi Medical University /Guigang People's Hospital Guigang Guangxi 537100 China Abstract Objective To investigate the effects of transurethral resection of the prostate TURP on lower urinary tract symptoms LUTS in patients with benign prostatic hyperplasia BPH complicated by histological prostatitis. Methods This study included 432 cases of BPH pathologically confirmed after TURP. Excluding those with LUTS-related factors before and after surgery and based on the international prostatitis histological classification of diagnostic criteria the remaining 144 cases were divided into groups A 1 2010GXNSFA013247 1964- Email even-lyw@ 163. com
36 pure BPH n = 30 B mild inflammation n = 55 C moderate inflammation n = 31 and D severe inflammation n = 28. Each group was evaluated for LUTS by IPSS before and a month after surgery. Results A total of 399 cases 92. 4% were diagnosed as BPH with histological prostatitis 269 67. 4% mild 86 21. 6% moderate and 44 11. 0% severe. The preoperative IPSS was 21. 43 ± 6. 09 in group A 21. 75 ± 5. 97 in B 27. 84 ± 4. 18 in C and 31. 00 ± 2. 92 in D with statistically significant differences among different groups P < 0. 001 except between A and B P = 1. 000 the postoperative IPSS was 5. 60 ± 2. 16 in A 7. 36 ± 2. 77 in B 11. 55 ± 3. 39 in C and 16. 89 ± 3. 37 in D with statistically significant differences among different groups P < 0. 01 and remarkably lower than the preoperative one P < 0. 001. Almost all the infiltrating inflammatory cells in BPH with histological prostatitis were lymphocytes. Conclusion BPH is mostly complicated with histological chronic prostatitis. The severity of LUTS is higher in BPH patients with histological prostatitis than in those without before and after TURP and positively correlated with the grade of inflammation. Those complicated with moderate or severe histological prostatitis should take medication for the management of LUTS. Natl J Androl 2013 19 1 35-39 Key words benign prostatic hyperplasia prostatitis lower urinary tract symptom transurethral resection of the prostate Supported by a grant from Natural Science Foundation of Guangxi Province 2010GXNSFA013247. Received May 27 2012 accepted September 24 2012 benign prostatic hyperplasia 5 BPH 6 7 TURP 8 1 BPH CP 9 lower urinary tract symptoms LUTS 1. 3 BPH 1. 3. 1 1 2 LUTS 3 1 1 BPH LUTS 4 1 α 5α 5 CP BPH LUTS 1 1. 1 2009 5 2011 5 TURP BPH 432 4 10 BPH CP HE CP IPSS PSA B IPSS PSA B 1. 2 1. 2. 1 1 BPH BPH CP BPH CP 2 1 D BPH α 5α 3 BPH chronic prostatitis CP 4 1. 3. 2 1. 4 TURP 2 4 1 BPH A BPH BPH B BPH BPH C 1. 2. 2 1 1. 5 LUTS IPSS 2 BPH 1 1
37 1 1. 6 SPSS 13. 0 1 A 30 1- t A B 55 1-B Spearman P < 0. 05 2 2. 1 432 CP BPH 399 92. 4% 269 67. 4% 86 21. 6% 44 11. 0% 144 C 31 1-C BPH D 28 1-D 1 HE 100 A B C D Figure 1. Pathological changes of the prostate tissue in different groups HE 100 A No inflammatory cell in the interstitium. B lymphocytes scattered in the interstitium. C lymphocytes gathered in the interstitium. D lymphoid nodule and the destroyed epithelial tissue of the gland. 2. 2 IPSS IPSS F = 91. 859 P < 0. 01 P < 0. 01 IPSS F = 27. 530 LSD P P < 0. 01 Levene < 0. 01 F = 10. 602 P < 0. 01 Dunnett T 3 A 21. 43 ± 6. 09 B 21. 75 ± 5. 97 0. 01 F = P = 1. 000 2. 252 P = 0. 090 P < 0. 01 IPSS 1 2 Levene F = 2. 635 P = 0. 052 Spearman r = 0. 562 P <
38 1 IPSS x ± s Table 1. IPSS in different groups before and after surgery x ± s Group n Preoperation Postoperation Difference A 30 21. 43 ± 6. 09 5. 60 ± 2. 16 a 15. 83 ± 5. 57 B 55 21. 75 ± 5. 97 7. 36 ± 2. 77 ab 14. 38 ± 5. 24 C 31 27. 84 ± 4. 18 bc 11. 55 ± 3. 39 abc 16. 29 ± 3. 94 D 28 31. 00 ± 2. 92 bcd 16. 89 ± 3. 37 abcd 14. 11 ± 3. 24 a P < 0. 01 A b P < LUTS 3 0. 01 B c P < 0. 01 C d P < 0. 01 IPSS AUA LUTS 0 ~ 7 8 ~ 19 20 ~ 35 BPH LUTS Nickel 12 a P < 0. 01 versus preoperation b P < 0. 01 versus Group A at BPH the same time c P < 0. 01 versus Group B at the same time d Spearman IPSS P < 0. 01 versus Group C at the same time. r = 0. 562 P < 0. 01 BPH BPH BPH LUTS TURP BPH LUTS IPSS BPH IPSS 2 IPSS IPSS Figure 2. Correlation of preoperative IPSS with the grade of inflammation F = 2. 252 P = 0. 090 IPSS 3 7. 36 ± 2. 77 BPH CP 3 11. 55 ± 3. 39 16. 89 ± 4-6 3. 37 7 BPH 87. 5% BPH ~ 100% 1 8-9 TURP LUTS 92. 4% 67. 4% BPH 21. 6% 11. 0% 10 4 13 58. 3% 22. 4% 19. 3% T National Institute of Health NIH 11 BPH BPH CP Ⅳ asymptomatic inflammatory prostatitis AIP BPH
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