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Transurethral resection of the prostate achieves favorable outcomes in stroke patients with symptomatic benign prostate hyperplasia
Authors:Chen-Pang Hou  Yu-Hsiang Lin  Tien-Hsing Chen  Phei-Lang Chang  Horng-Heng Juang  Chien-Lun Chen
Institution:1. Department of Urology, Chang Gung Memorial Hospital at Linkou, Tao-Yuan, Taiwan, Republic of China;2. School of Medicine, Chang Gung University, Tao-Yuan, Taiwan, Republic of China;3. Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan, Republic of China;4. School of Medicine, Chang Gung University, Tao-Yuan, Taiwan, Republic of China;5. Division of Cardiology, Department of Internal medicine, Chang Gung Memorial Hospital, Keelung, Taiwan, Republic of China;6. Department of Anatomy, School of Medicine, Chang Gung University, Tao-Yuan, Taiwan, Republic of China
Abstract:Objectives: To evaluate the surgical outcomes of stroke patients with symptomatic benign prostatic hyperplasia (BPH) who underwent transurethral resection of the prostate (TURP) and compare the clinical outcomes between patients with stroke and those without stroke receiving this procedure.

Methods: This retrospective cohort study analyzed claims data collected during the period of 1997–2012 from Taiwan National Health Insurance Research Database. We enrolled 6625 patients who had persistent lower urinary tract symptoms and underwent TURP for BPH. They were categorized into a stroke (n?=?577) and nonstroke (n?=?6048) group. Patient characteristics, postoperative clinical outcomes, medication records, and medical expenses were compared.

Results: Compared with the stroke group patients, those in the nonstroke group were younger, had fewer comorbidities, and more favorable postoperative clinical outcomes. Nevertheless, TURP achieved favorable outcomes in stroke patients with symptomatic BPH. In the stroke group, the rate of urinary tract infection (UTI) decreased from 34.7% during 1 year preoperatively to 29.8% during 1 year postoperatively (p?=?.05). The rate of urinary retention (UR) also decreased from 55.5% during 1 year preoperatively to 22.5% during 1 year postoperatively (p?=?.05). TURP reduced the overall medical expenses of patients with stroke. Annual patient medical expense during 1 year preoperatively, 1 year postoperatively, 2 years postoperatively, and 3 years postoperatively was NT$659,000, NT$646,000, NT$560,000, and NT$599,000, respectively.

Conclusions: In patients with stroke, TURP reduces the risks of UTI and UR and annual total medical expense.
Keywords:Benign prostate hyperplasia  aging male  stroke  prostatectomy  lower urinary tract syndrome
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