Number №2, 2019 - page 70-79

Selection of drug therapy in patients after bipolar transurethral resection of the prostatedepending on its original size DOI: 10.29188/2222-8543-2019-11-2-70-78

Martov A.G., Turin D.E., Ergakov D.V., Andronov A.S., Kamalov A.A.
Information about authors:
  • Martov A.G. – Dr. Sci., professor, head of the Department of Urology and Andrology of Federal Medical and Biological Center named aer A.I. Burnazyana FMBA RF, Head of the Urology Department of State Budgetary Health city hospital named aer D.D. Pletnev, martovalex@mail.ru, ORCID 0000-0001-6324-6110
  • Yergakov D.V. – PhD, Associate Professor of the Department of Urology and Androlog of Federal Medical and Biological Center named aer A.I. Burnazyana FMBA RF, urologist of the Urology Department of State Budgetary Health city hospital named aer D.D. Pletnev; dergakov@mail.ru, ORCID 0000-0003-1682-7208
  • Turin D.E. – postgraduate student of the department of urology and andrology of Federal Medical and Biological Center named aer A.I. Burnazyana FMBA RF, urologist of «12 CDC» of the Ministry of Defense of the Russian Federation, dmit.turin2013@yandex.ru
  • Andronov A.S. – PhD, Assistant of the Department of Urology and Andrology of Federal Medical and Biological Center named aer A.I. Burnazyana FMBA RF, urologist of the Urology Department of State Budgetary Health city hospital named aer D.D. Pletnev, dr.andronov@mail.ru, ORCID 0000-0002-7831-2990
  • Kamalov A.A. – Dr. Sci., professor, academician of the Russian Academy of Sciences, director of Moscow International Medical Center M.V. Lomonosov, roo.rusmh@gmail.com
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Introduction. This study was aimed at dynamic evaluation of lower urinary tract symptoms (LUTS) after endoscopic surgery for benign prostatic hyperplasia (BPH) depending on prostate volume.

Materials and methods: between January 2017 and February 2018, 288 bipolar transurethral resections were performed for BPH in D.D. Pletnev City Clinical Hospital. Twenty seven patients were excluded from this study. Depending on baseline BPH volume patients (n = 261) were distributed among three groups: 1 - less than 40 cc (n = 93), 2 - between 40 and 80 cc (n = 102), 3 – over 80 cc (n = 66). Depending on therapy every group was separated into three subgroups comprising of 31 (group 1), 34 (group 2) and 22 (group 3) patients each: subgroup I was treated with antibacterial drug and non-steroid anti-inflammatory drug suppositoria for 7 days, subgroup II additionally received tamsulosin for 3 months, and group III received tamsulosin and 6 mg solifenacin for 3 months. The following parameters were monitored: visual analog score (VAS, 0- 100), IPSS, QoL, post-void residual volume (PVR), uroflowmetry, mean voiding volume (MVV).

Results: baseline VAS was 41-48 points, 1 month after in subgroups I - 57-63 points, 3 months after – 72-81 points. In subgroups II - 65-78 and 81-85 points. In subgroups III - 84-91 and 91-93 respectively. The larger the initial volume of prostate, the greater improvement in IPSS and QoL was achieved, and the greater beneficial effect was obtained with tamsulosin and solifenacin. MVV in subgroup I was 140-180 ml, and after removal of large volume BPH this parameter was smaller than in smaller BPH volume. In subgroups II and III MVV was higher than in subgroups I, while in subgroups III it was higher than in subgroups II.

Conclusion: combined therapy forresidual LUTS has benefits when compared to alpha-blockers and standard postoperative therapy

Authors declare lack of the possible conflicts of interests.

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benign prostatic hyperplasia, lower urinary tract symptoms, transurethral resection of the prostate, postoperative period, treatment, alpha-adrenoblockers, M-anticholinergics

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