Prostate resection weight matters in severely obstructed men undergoing transurethral resection of the prostate

Objectives: Transurethral resection of the prostate (TURP) remains one of the goldstandard surgical treatments for benign prostatic hyperplasia/lower urinary tract symptoms. The usefulness of a complete adenoma resection is questionable, with studies reporting no impact of the amount of resected tissue on surgical outcomes, irrespective of prostate volume. The aim of this study was to assess whether in less obstructed patients a less extensive TURP may be considered. Materials and methods: Retrospective analysis of 185 men undergoing TURP in one university hospital. Retrieved data included pre-operative prostate volume and Q_max, as well as resected prostate weight and post-operative Q_max. Patients were divided in two groups according to pre-operative Q_max < 10mL/s and ≥ 10 mL/s. Results: A correlation was found between absolute resected prostate weight and post-operative Q_max in the group of patients with pre-operative Q_max < 10 mL/s (r² = 0.038, p = 0.032), independently of the pre-operative prostate volume. This association was neither observed in the group of patients with pre-operative Q_max ≥ 10 mL/s (r² = -0.033, p = 0.796) nor in whole population analysis (r² = 0.019, p = 0.064). Likewise, in the group of patients with pre-operative Q_max < 10 mL/s, the improvement in Q_max was correlated with absolute resected weight and percentage of prostate resected weight (r² = 0.036, p = 0.037 and r² = 0.040, p = 0.029, respectively). None of these correlations was found in the group of patients with pre-operative Q_max ≥ 10 mL/s (r² = 0.009, p = 0.463 and r² = -0.018, p = 0.294, respectively). Conclusions: Patients with pre-operative Q_max ≥ 10 mL/s may do well with less profound prostate resections, whereas patients with lower pre-operative Q_max seem to benefit from a complete adenoma resection.