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Category: Volume 07 Issue 09 September 2019
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Title: Predictive Value of Inflammatory Markers in determining anterior urethral stricture after transurethral resection of prostate

Authors: Venugopalan A.V, Shanmugha Das K.V, Rayeez Rasheed, Felix Cardoza

 DOI: https://dx.doi.org/10.18535/jmscr/v7i9.116

Abstract

  

Objective: To investigate the relationship between preoperative Neutrophil to lymphocyte ratio (NLR) and Platelet to Lymphocyte ratio (PLR) values and post TURP strictures.

Patients and Methods: A retrospective review of data regarding preoperative absolute neutrophil, lymphocyte and platelet count were recorded for all patients who underwent TURP for benign prostatic hyperplasia in Urology Department from January 2017 to December 2017. Patients who had posterior urethral strictures, documented active infection at the time of TURP, surgery for any other urethral pathology and previous or ongoing treatment for any cancer and hematologic disorders were excluded. Study group comprised of 285 cases. NLR and PLR were calculated. Diagnosis of urethral stricture was suspected when uroflowmetry showed a maximum flow rate of less than 10 mL per second and was confirmed by both urethrogram and cystoscopyin each stricture patient. Receiver operating characteristic (ROC) curve was drawn to determine the cut off value of PLR and NLR for predicting stricture.

Results: Statistically significant differences were observed between the groups in terms of prostate volume, operating time, NLR and PLR. For predicting urethral stricture, the optimal cut-off value of PLR was 111.895, (sensitivity: 1, specificity: 1; AUC=1) and NLR was 2.33 [sensitivity: 0.82; specificity:0.6; AUC=0.721 (0.637 - 0.805)].

Conclusion: There is a definite correlation between inflammatory markers and urethral stricture formation. Both PLR and NLR can be used to determine the probability of development of urethral stricture in patients after TURP.

Keywords: Inflammatory markers, Neutrophil to lymphocyte ratio (NLR), Platelet to Lymphocyte ratio (PLR), Post-TURP stricture.

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Corresponding Author

Shanmugha Das K.V

Department of Urology, Government Medical College, Kozhikode, Kerala University of Health Sciences