title: Establishment and value assessment of efficacy prediction model about transurethral prostatectomy.
abstract: OBJECTIVE
  To establish and to evaluate discriminant models to predict the outcomes of transurethral prostatectomy.
  
  
  METHODS
  Clinical data of patients treated with transurethral prostatectomy between January and December 2013 were collected, including medical history, symptoms, biochemical tests, ultrasonography and urodynamics. Surgical efficacy was evaluated at 6-month follow up. Predictive models were constructed by logistic regression. Receiver operating characteristic curve and diagnostic tests were used to test the accuracy of models before the predictive value between models was compared.
  
  
  RESULTS
  A total of 182 patients were included, with 73.6% having an effective outcome. History of recurrent urinary tract infection (OR 1.33), score of storage phase (OR 2.58), maximum flow rate (OR 2.11) and detrusor overactivity (OR 3.13) were found to be risk factors. International Prostate Symptom Score (OR 0.13), transitional zone index (OR 0.58), resistive index of prostatic artery (OR 0.46), bladder wall thickness (OR 0.78), ultrasonic estimation of bladder weight (OR 0.28), bladder outlet obstruction index (OR 0.20) and bladder contractility index (OR 0.83) were found to be protective factors. The areas under the curve of models using factors from ultrasonography and urodynamics were 0.792 and 0.829 respectively, with no significant difference being found between them (P = 0.348).
  
  
  CONCLUSIONS
  Surgical efficacy of transurethral prostatectomy is positively correlated to severe voiding phase symptoms, outlet obstruction and better detrusor contractility, and negative correlated with urinary infection, severe storage phase symptoms and excessive detrusor contractibility. Ultrasonography might replace urodynamics in selecting patients for whom transurethral prostatectomy is more likely to be beneficial.
authors.affiliation: Department of Urology, Anhui Provincial Hospital, Hefei, Anhui, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Huang
authors.affiliation: Department of Urology, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Yangpu, Shanghai, China.
authors.forename: Yong Jiang
authors.initials: YJ
authors.lastname: Yu
authors.affiliation: Department of Urology, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Yangpu, Shanghai, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Qi
authors.affiliation: Department of Urology, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Yangpu, Shanghai, China.
authors.forename: Ding
authors.initials: D
authors.lastname: Xu
authors.affiliation: Department of Urology, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Yangpu, Shanghai, China.
authors.forename: Liu Jian
authors.initials: LJ
authors.lastname: Duan
authors.affiliation: Department of Urology, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Yangpu, Shanghai, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Ding
authors.affiliation: Department of Urology, Anhui Provincial Hospital, Hefei, Anhui, China.
authors.forename: Yu Ping
authors.initials: YP
authors.lastname: Zhu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D016002:Discriminant Analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D009119:Muscle Contraction; D018482:Muscle, Skeletal / Q000503:physiopathology; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011470:Prostatic Hyperplasia / Q000150:complications; D053448:Prostatism / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery*; D012372:ROC Curve; D012720:Severity of Illness Index; D020728:Transurethral Resection of Prostate; D016896:Treatment Outcome; D014463:Ultrasonography; D001743:Urinary Bladder / Q000503:physiopathology; D001748:Urinary Bladder Neck Obstruction / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery*; D014563:Urodynamics
keywords: predictive model; transurethral resection of prostate; treatment outcome; ultrasonography; urodynamics