To investigate whether the pre- and postoperative International Prostate Symptom Score (IPSS) change predicts the outcome of transurethral prostatectomy in a Taiwanese population, 99 patients (transurethral prostatectomy candidates) were assessed with the IPSS before and 6-12 months after surgery. All symptoms improved significantly postoperatively. Patients with a greater preoperative IPSS benefited the most. Improvements in preoperative obstructive symptoms (incomplete emptying, intermittency, straining, and weak stream) were greater than those in irritable symptoms (urgency, frequency, and nocturia). A significant correlation was found between IPSS and quality of life (QOL) before and after transurethral prostatectomy. A change of 1 unit on the IPSS scale was found to decrease the QOL score 0.282 units. The positive predictive value of a >or=7-IPSS point decrease depended on the predictive IPSS criteria applied. When the preoperative IPSS was more than 17, the sensitivity was 83.5% and specificity was 30%. Postoperative improvement did not differ significantly between acute urinary retention (AUR) and non-AUR patients. Change in IPSS of more than 7 points predicted symptomatic improvement with high sensitivity. The predictive value depends on the definition of significant improvement (magnitude of IPSS change) and on the level of IPSS symptoms (sufficient to warrant transurethral prostatectomy).
We sought to identify factors influencing dose maintenance of intracavernous (IC) injection among patients with ED following radical prostatectomy. A total of 93 patients underwent prostatectomy and received IC treatment for ED, including PGE1 single therapy (n ¼ 53) and triple therapy (n ¼ 40). In the PGE1-only group, the maintenance dosage was significantly correlated with preoperative sexual function and nerve sparing (NS) (Po0.05). For example, the maintenance dose among patients with no, unilateral and bilateral NS was 10.8 ± 6.6 lg (0.54 ± 0.33 ml), 10.8 ± 3.8 lg (0.54 ± 0.19 ml) and 6.4 ± 4.6 lg (0.32 ± 0.23 ml), respectively. In terms of preoperative sexual function, the maintenance dose among non-ED versus ED patients was 0.38±0.25 ml (7.6±5.0 lg) and 0.59±0.31 ml (11.8±6.2 lg), respectively. No significant correlation was observed between the maintenance dose and NS or preoperative sexual function among the triple-therapy patients or between the maintenance dose and age, body mass index, systemic diseases and initiation of ED treatment among all patients (P40.05). Thus, maintenance dose of PGE1 therapy could be partly determined by NS status and prior ED of patients.
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