PDF(Pubmed)
Abstract：
UNASSIGNED: There is a rising prevalence of benign prostatic hyperplasia (BPH)-related urinary symptoms along with erectile dysfunction in the aging male population. Therefore, assessment of lower urinary tract symptoms (LUTS) is advised before penile prosthesis surgery with some men requiring preoperative transurethral surgical management to reduce the risk of post-procedure complications. However, less is known about the natural history of men with uncomplicated LUTS who do not require surgical management for BPH before penile prosthesis.
UNASSIGNED: We sought to assess the natural history of BPH-related uncomplicated LUTS in men following penile prosthesis surgery.
UNASSIGNED: Single institution retrospective review.
UNASSIGNED: Following institutional review board approval, we performed a retrospective review of all adult males with a preoperative diagnosis of LUTS undergoing penile prosthesis surgery at our institution from January 2017 to November 2022. The primary outcome was progression to transurethral surgery.
UNASSIGNED: From 2017 to 2022, 211 patients with preexisting LUTS underwent penile prosthesis surgery and met all criteria for inclusion including no history of transurethral surgery. The median (interquartile range, IQR) AUA symptom score (AUA-SS) was 12 (12). Post-void residual was below 200 cc in 96.2% of patients preoperatively and 99.1% of patients after surgery. At a median (IQR) follow-up duration of 9 (23) months after surgery, 5.7% (12/211) of patients had progressed to bladder outlet surgery and 35.5% of patients endorsed LUTS bother with a median (IQR) AUA-SS of 14.5 (11.8).
UNASSIGNED: The majority of patients with uncomplicated LUTS did not require bladder outlet surgery following penile prosthesis implantation and could be managed with conservative or pharmacologic measures alone. Prostate gland size was significantly larger in patients who progressed to bladder outlet surgery. While the results are overall reassuring, further study is needed to identify specific factors associated with pursuing bladder outlet surgery in this small subset of patients.
UNASSIGNED: We sought to assess the natural history of BPH-related uncomplicated LUTS in men following penile prosthesis surgery.
UNASSIGNED: Single institution retrospective review.
UNASSIGNED: Following institutional review board approval, we performed a retrospective review of all adult males with a preoperative diagnosis of LUTS undergoing penile prosthesis surgery at our institution from January 2017 to November 2022. The primary outcome was progression to transurethral surgery.
UNASSIGNED: From 2017 to 2022, 211 patients with preexisting LUTS underwent penile prosthesis surgery and met all criteria for inclusion including no history of transurethral surgery. The median (interquartile range, IQR) AUA symptom score (AUA-SS) was 12 (12). Post-void residual was below 200 cc in 96.2% of patients preoperatively and 99.1% of patients after surgery. At a median (IQR) follow-up duration of 9 (23) months after surgery, 5.7% (12/211) of patients had progressed to bladder outlet surgery and 35.5% of patients endorsed LUTS bother with a median (IQR) AUA-SS of 14.5 (11.8).
UNASSIGNED: The majority of patients with uncomplicated LUTS did not require bladder outlet surgery following penile prosthesis implantation and could be managed with conservative or pharmacologic measures alone. Prostate gland size was significantly larger in patients who progressed to bladder outlet surgery. While the results are overall reassuring, further study is needed to identify specific factors associated with pursuing bladder outlet surgery in this small subset of patients.
摘要：
■在老年男性人群中，良性前列腺增生（BPH）相关的泌尿系统症状以及勃起功能障碍的患病率正在上升。因此,建议在阴茎假体手术前评估下尿路症状(LUTS),一些男性需要术前经尿道手术治疗,以降低术后并发症的风险.然而,对患有不复杂的LUTS的男性的自然史知之甚少，他们不需要在阴茎假体前进行BPH的手术治疗。
■我们试图评估男性阴茎假体手术后BPH相关无并发症LUTS的自然史。
■单一机构回顾性审查。
■在机构审查委员会批准后，我们对2017年1月至2022年11月在我们机构接受阴茎假体手术的术前诊断为LUTS的所有成年男性进行了回顾性研究.主要结果是进展到经尿道手术。
■从2017年到2022年，有211例先前存在的LUTS患者接受了阴茎假体手术，并符合所有纳入标准，包括无经尿道手术史。中位数(四分位数间距，IQR)AUA症状评分(AUA-SS)为12(12)。在96.2％的患者和99.1％的患者中，术后空隙残留低于200cc。在手术后9（23）个月的中位（IQR）随访时间，5.7％（12/211）的患者进行了膀胱出口手术，35.5％的患者认可LUTS，中位数（IQR）AUA-SS为14.5（11.8）。
■大多数无并发症的LUTS患者在阴茎假体植入后不需要进行膀胱出口手术，可以单独通过保守或药物治疗。进展到膀胱出口手术的患者前列腺大小明显更大。虽然结果总体令人放心，在这一小部分患者中,需要进一步研究确定与进行膀胱出口手术相关的具体因素.
■我们试图评估男性阴茎假体手术后BPH相关无并发症LUTS的自然史。
■单一机构回顾性审查。
■在机构审查委员会批准后，我们对2017年1月至2022年11月在我们机构接受阴茎假体手术的术前诊断为LUTS的所有成年男性进行了回顾性研究.主要结果是进展到经尿道手术。
■从2017年到2022年，有211例先前存在的LUTS患者接受了阴茎假体手术，并符合所有纳入标准，包括无经尿道手术史。中位数(四分位数间距，IQR)AUA症状评分(AUA-SS)为12(12)。在96.2％的患者和99.1％的患者中，术后空隙残留低于200cc。在手术后9（23）个月的中位（IQR）随访时间，5.7％（12/211）的患者进行了膀胱出口手术，35.5％的患者认可LUTS，中位数（IQR）AUA-SS为14.5（11.8）。
■大多数无并发症的LUTS患者在阴茎假体植入后不需要进行膀胱出口手术，可以单独通过保守或药物治疗。进展到膀胱出口手术的患者前列腺大小明显更大。虽然结果总体令人放心，在这一小部分患者中,需要进一步研究确定与进行膀胱出口手术相关的具体因素.
