43rd Annual Congress of the Italian Urodynamic Society, Rome, Italy, 13th-15th June 2019: Role of the preoperative post void residual urine in males underwent turp for lower urinary tract symptoms

Introduction and aim of the study: The role of post void residual (PVR) urine in the evaluation of men with lower urinary tract symptoms (LUTS) is still controversial due to the missing standardization of PVR pathological thresholds. Therefore, the influence of PVR on the decision‐making of treatments for males with LUTS remains unclear. Aim of this study was to assess the role and the values of the preoperative PVR in males underwent transurethral resection of the prostate (TURP) for LUTS and the related outcomes after the procedure. Materials and methods: This is a prospective ongoing study started in January 2017 involving males with LUTS candidates for TURP. The medical and urological history was recorded in all the population. Both preoperative evaluation and the 1‐year follow‐up consisted in: peak flow (Qmax), PVR, PVR‐ratio as the ratio of PVR to bladder volume (BV: voided volume + PVR), and the International Prostate Symptoms Score Questionnaire (IPSS). Patients were also distributed in groups according to preoperative PVR thresholds: i) PVR 0‐50ml; ii) PVR 51‐100ml; iii) PVR 101‐150ml; iiii) PVR 151‐200ml; iiiii) PVR>200ml. Statistical analysis was performed using T‐test, Wilcoxon test, one‐way ANOVA test, the Kruskal‐Wallis Test.Results: Data were complete in 52 patients, with a mean age of 68.9+8.5 years. A significant improvement in voided volume, Qmax, PVR, IPSS score was documented (Table 1). The majority of the males showed a PVR <100ml (59.6%), while the remaining 21/52 patients (40.4%) had a PVR >100ml. No significant difference was found in Qmax and IPSS score among the groups, in both preoperative and postoperative assessment (Table 2). In each group we found a significant improvement in Qmax and IPSS score after prostate resection. Interpretation of results: Only a minor part of the males showed a high preoperative PVR (>100ml), therefore PVR did not have a crucial role in the decision‐making. Quite the reverse, Qmax and symptoms score had the main influence. PVR was not correlated to preoperative and postoperative Qmax and IPSS. This finding suggests that PVR was a poor predictive factor for the decision‐making and outcomes in males candidates for TURP. Conclusions: In our cohort a high PVR was present only in a minority of patients candidates for TURP and did not significantly influence the outcomes of TURP. This study confirmed that PVR is still a controversial and poor reliable parameter in the evaluation of males with LUTS as well in the treatments’ decision‐making.