Effects of residual prostatic calculi on lower urinary tract symptoms after transurethral resection of prostate

Purpose: We investigated whether the removal of prostatic calculi, through a transurethral resection of the prostate (TURP), in benign prostatic hyperplasia (BPH), can improve the lower urinary tract symptoms (LUTS). Materials and methods: Between March 2000 and February 2003, four hundred and thirty-two patients underwent TURP. Of these, one hundred and eighty-three were postoperatively evaluated with transrectal ultrasound (TRUS), International Prostate Symptom Score (IPSS) and uroflowmetry. The one hundred and eighty-three patients were divided into two groups, those with and without prostatic calculi. The group with prostatic calculi was further divided into three groups according to the location of the prostatic calculi (periurethral, periadenoma and diffuse types). The surgical outcomes were evaluated and compared between the two groups and according to the location of the prostatic calculi. Results: Prostatic calculi were detected in 108 of the 183 cases (59%). The mean patient age, prostate volume and serum prostate-specific antigen (PSA) level were no different between the two groups. Both groups, those with and without prostatic calculi, showed improvements of their LUTS after the TURP. The prostatic calculi group showed more significant improvements in the peak uroflow (Qmax), quality of life (QoL) and IPSS compared to those of the non- prostatic calculi group (p < 0.05). In the prostatic calculi group, statistically significant differences were seen between the periurethral and periadenoma location types (p < 0.05). Conclusions: These results suggest that the removal of prostatic calculi through TURP can improve the LUTS, and their locations are related to the operational results. Patients with symptomatic BPH, combined with prostatic calculi, seem to be strong candidates for surgical intervention, compared to those without prostatic calculi, for improvements of their LUTS.