Application of Shared Decision Making in Benign Prostate Hyperplasia Surgery

• Main Authors: CHEN,BO-HAN, 陳柏翰
• Other Authors: WU, WEN-HSIAN
• Format: Others
• Language: zh-TW
• Published: 2019
• Online Access: http://ndltd.ncl.edu.tw/handle/n7pxzk

碩士 === 元培醫事科技大學 === 醫務管理系碩士在職專班 === 107 === Objective: Intravesical prostatic protrusion (IPP) has been used as a factor for evaluating the outcome of medical treatments for patients having benign prostate enlargement (BPE). This prospective study aimed to examine whether IPP may become a predictor for surgical therapeutic response in elderly patients with unsatisfied medical therapy for BPE. Materials and Methods: 62 patients complained of lower urinary tract symptoms (LUTS) and diagnosed as BPE and received transurethral resection of prostate (TURP) or laser enucleation of prostate (TULEP) were enrolled. The patients were grouped according to their IPP value (group A: IPP ≤ 1cm and group B, IPP> 1cm). Baseline parameters, including international prostate symptom score (IPSS), quality of life score, postvoid residual urine volume, prostate-specific antigen, maximal urinary flow rate (Qmax) and data obtained from transabdominal ultrasonography were collected and analyzed before and after the surgical treatment. Results: After 3 months of treatment, patients in group B had a significantly better outcome in Qmax (10.6ml/s vs. 5.5ml/s, p =0.001) and IPSS (51.4% vs. 34% p =0.001) than in group A. Multivariable logistic regression analysis showed significant predicting therapeutic factor of IPSS improvement such as age, IPP, and PSA. Besides, Age and IPP length also were associated with Qmax improvement. No major adverse event occurred. Conclusions: IPP may be a critical predictor for surgical outcome in elderly men with LUST due to benign prostatic obstruction and prostate volume >30ml.