Hypothesis / aims of study
Recently, trifecta outcome has been proposed to evaluate transurethral resection of prostate outcome. Aim of our study was to evaluate the risk factors for favourable trifecta outcome in patients with lower urinary tract symptoms and benign prostatic enlargement (LUTS-BPE) undergoing transurethral resection of prostate (TURP).
Study design, materials and methods
From 2015 onward, a consecutive series of patients with LUTS-BPE undergoing transurethral resection of prostate were propectively enrolled. Patients were evaluated using the International Prostate Symptom Score (IPSS), uroflowmetry and transrectal ultrasound prostate volume assessment (TRUS). Metabolic syndrome (MetS) was defined according to Adult Treatment Panel III (ATP III). Outcomes were evaluated considering the trifecta favourable outcome which was defined as a combination of the following items: (1) no perioperative complications, (2) postoperative IPSS <8, and (3) postoperative Qmax >15 ml/s. Based on the logistic regression analysis a nomogram was generated. Discrimination, calibration and net benefit was assessed using LROC, calibration plots and decision curve analysis.
Interpretation of results
On multivariate analysis preoperative low IPSS, preoperative high Qmax and absence of MetS were independent predictors of trifecta. The predicted accuracy of the model was 0,76. Calibration of the model was excellent (p=0.91). A net benefit was recorded in the range of probabilities between 35 and 95%.