The outcome of transurethral resection of prostate in uncontrolled diabetic patients and its predicting factors: a prospective cohort study

Abstract Background Diabetics have significantly greater BPH severity of symptoms when compared with the healthy controls. This study aims to evaluate the outcome of transurethral resection of the prostate in uncontrolled diabetic patients and identify the predicting factors of success. Methods A cohort study of 40 male patients with uncontrolled diabetes mellitus (DM) presented with lower urinary tract symptoms (LUTS) caused by benign prostatic hyperplasia (BPH) based on history, physical findings and relevant investigations and indicated for transurethral resection of the prostate (TURP). Patients with neurological diseases, stroke or history of endoscopic or surgical treatment of BPH were excluded. Bi-polar TURP with spinal anesthesia was done for all patients by the same team. All patients were pre- and postoperatively evaluated by IPSS, quality of life (Qol), postvoid residual urine (PVR), urine, uroflowmetry and pressure flow urodynamic study. Scheduled follow-up visits (2 weeks, 1, 3 and 12 months) were documented to assess the outcome postoperatively. Results 40 male patients with mean age 66.1 ± 7.4 years old, mean HbA1C 8.18 ± 1.2 and mean prostate size 69.3 ± 8.9cc were included in the study. Twenty of them presented with repeated urine retention despite of using alpha blocker. There was significant improvement as regard maximum flow (Qmax), residual urine (PVR), Quality of life score (Qol), IPSS and bladder contractility index (BCI) postoperatively. Correlation of these parameters improvement and preoperative factors showed significant correlation between this improvement and preoperative BCI, age, duration of diabetes, HbA1c, PVR, infected urine culture, preoperative IPSS and bladder capacity ( P values ≤ 0.0001). No significant correlation was found between the outcome of TURP, bladder capacity and prostate volume. Conclusions TURP is safe and effective modality of treatment for uncontrolled diabetic patients with BPH. Patients’ age, duration of diabetes, HbA1c, preoperative BCI and IPSS were good predictors of TURP success in such cases.