COMPARISON OF UROFLOWMETRIC PARAMETERS PRE AND POST TRANSURETHRAL RESECTION OF PROSTATE (TURP) IN BENIGN PROSTATIC HYPERPLASIA (BPH) USING MOBILE APPLICATION UROFLOWMETRY
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Keywords
benign prostatic hyperplasia, transurethral resection of prostate, uroflowmetry, mobile application, urinary flow, patient-reported outcomes
Abstract
Background: Benign prostatic hyperplasia (BPH) is a common cause of lower urinary tract symptoms in aging men. Transurethral resection of the prostate (TURP) is the gold standard surgical treatment, leading to significant improvements in urinary flow and symptom relief. Traditional uroflowmetry requires clinic-based equipment, whereas mobile application–based uroflowmetry offers a convenient, patient-centered alternative.
Objective: To compare uroflowmetric parameters before and after TURP in patients with BPH using mobile application uroflowmetry and to assess predictors of postoperative improvement.
Methods: This prospective comparative study included 180 male patients with BPH undergoing TURP at Department of Urology, PIMS Islamabad, from June 2024 to September 2024. Baseline demographic and clinical data were collected. Uroflowmetric parameters, including maximum flow rate (Qmax), average flow rate (Qavg), voided volume, and flow time, were measured pre- and post-operatively using a validated mobile uroflowmetry application. Symptom burden was assessed with the International Prostate Symptom Score (IPSS) and quality of life (QoL) scores. Postoperative complications were recorded. Data were analyzed using paired t-tests, chi-square tests, and multivariable logistic regression, with p≤0.05 considered significant.
Results: The mean age was 66.2 ± 8.4 years. Following TURP, Qmax improved from 8.2 ± 2.5 to 18.6 ± 4.3 mL/s (p<0.001), Qavg increased from 4.1 ± 1.3 to 9.2 ± 2.1 mL/s (p<0.001), and voided volume rose from 172 ± 46 to 238 ± 58 mL (p<0.001). Flow time decreased from 42.8 ± 11.7 to 28.6 ± 9.5 seconds (p<0.001). IPSS scores dropped from 21.2 ± 6.4 to 7.6 ± 3.8 (p<0.001), nocturia frequency reduced from 3.1 to 1.2 per night, and QoL scores improved from 4.8 to 1.9 (p<0.001). Complications included hematuria (8.3%), urinary tract infection (6.7%), transient incontinence (5.0%), retrograde ejaculation (22.8%), and urethral stricture (3.3%). Multivariable analysis showed that prostate size >60 mL (aOR 2.11, p=0.004), baseline Qmax <8 mL/s (aOR 2.62, p<0.001), and age <70 years (aOR 1.78, p=0.02) predicted greater improvement.
Conclusion: TURP significantly improves uroflowmetric parameters, symptom scores, and quality of life in patients with BPH. Mobile application–based uroflowmetry is a practical and reliable tool for pre- and postoperative assessment, offering a convenient and patient-friendly alternative to conventional flowmetry. Larger prostate size, younger age, and lower baseline flow rates predict better outcomes.
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Dr Muhammad Abbas
Department of Urology PIMS Islamabad
Dr Irfan Ahmed
Department of Urology PIMS Islamabad
Dr Mohibullah
Department of Urology PIMS Islamabad
Dr Shiria Pahooja
Department of Urology PIMS Islamabad
Dr Hafiz Muhammad Sohaib Khalid
Department of Urology PIMS Islamabad
Dr Sanaullah
Department of Urology PIMS Islamabad