Study design, materials and methods
This is a prospective analysis of 107 patients over 40 years with LUTS secondary to BPH who underwent surgery between March 2020 and October 2023. Patients' characteristics were assessed, and symptoms were recorded using the IPSS and ICIQ male LUTS (ICIQ-MLUTS) preoperatively and at 3 and 6 months postoperative.
Results
A total of 46 patients (42%) underwent transurethral resection of the prostate (TURP), 35 (32%) underwent open prostatectomy, and 26 (24%) underwent Thulium laser enucleation (ThuLEP). The mean age of the patients was similar across groups.
The average prostate volume was 90 cc. 91% of patients reported at least one storage symptom before surgery, with urinary urgency and post-void dribbling having the most impact on quality of life. A significant improvement in storage LUTS was considered as a reduction of at least 30% in the ICIQ- MLUTS storage subscore. We found an improvement of 71% and 73% in this subgroup of symptoms at 3 and 6 months postoperatively, respectively, and a worsening of 10.2% and 5.6%, respectively. At 6-month follow-up, the highest percentage of improvement was in the Thulium laser enucleation group (92.3%), followed by TURP. During follow-up, urinary urgency was the symptom with the highest reduction rate (51.4%), followed by urge urinary incontinence (34.5%) and post-void dribbling (32.7%).
Interpretation of results
The three evaluated procedures demonstrate comparable clinical and demographic characteristics, although with some differences in comorbidity prevalence. Storage symptoms (including nocturia) showed a progressive decrease, indicating a sustained clinical improvement. These findings support the efficacy of surgical intervention of BPH/LUTS in relievieng storage symptoms and contribute to informed clinical decision-making in the management of BPH.