INTRODUCTION Benign Prostate Hyperplasia is a common disease in adult men and its incidence is age related. Prevalence of BPH is approximately 25% in men aged 40 to 49 years, 50% in men aged 50 to 59 years and 80% in men aged 70 to 79 years. 1 Renal failure and symptomatic benign prostatic hyperplasia (BPH) are two common health problems, they usually co-exist in 5.9–13.6% of the male population over 50 years of age. Actually going by the natural history of the disease and its progression with relation to Benign prostatic hyperplasia and its complications, it is noted that 13.6% of patients who presented to undergo Transurethral resection were in renal failure. It is usually not clear in this group of patients whether the reason for renal insufciency is or is not Benign prostatic hyperplasia. However, it has been reported in some studies that the incidence of diabetes mellitus and hypertension is higher in patients with renal failure (RF) and lower urinary tract symptoms (LUTS) due to Benign prostatic hyperplasia. On the other hand, it is known that due to chronic urinary obstruction, BPH can lead to renal failure and even death occasionally. TURP remains the gold standard surgical procedure for treatment of these cases. However, patients in renal failure have an increased risk for complications after TURP compared with patients with normal renal function, so we wanted to study the treatment outcome and complications associated with its management. The purpose of this study was to determine the incidence of renal failure associated with BPH , effect of TURP in the morbilidity and mortality of patients with renal failure. MATERIALS AND METHODS Prospective study from October 2017 to November 2019 SETTING : Govt. Stanley Medical college and Hospital, Chennai, This is a clinical study of 80 cases of Benign prostatic hyperplasia in normal and in patients with non dialysis requiring renal failure who underwent surgical therapy-TURP. PATIENT SELECTION INCLUSION CRITERIA All patients with Non dialysis requiring Renal Dysfunction associated with Benign Enlargement of Prostate in the Department of Urology in our institute. EXCLUSION CRITERIA Histologically proven malignant prostatomegaly Patients undergoing open prostatectomy RESULTS Patients with end stage renal disease requiring hemodialysis. In a total of 20 patients in Group 1, the youngest was 45 years and oldest was 83 years with a mean age of 64 years and standard deviation of 5.62 with the predominant age group 61- 70 years. PSS (majority had obstructive symptoms) with a mean score of 28.95 in Group 1 and 26.65 in Group 2 ,minimum and maximum score of 19 and 235 respectively with a standard deviation of 1.98. On analysis of IPSS score it was found that mean obstructive symptoms score was 15.3 as compared to the mean irritative symptoms score of 11.5. Comparing the prostate size by ultrasound in both groups, the mean prostate volume was 46cc in group 1 with a standard deviation of 12.47 and 42 cc in group 2 with a standard deviation of 14.19. Once the serum creatinine values stabilized, the readings PROSPECTIVE STUDY OF EFFECTS OF TURP ON OUTCOME,MORBIDITY AND MORTALITY IN PATIENTS WITH NON DIALYSIS REQUIRING RENAL INSUFFICIENCY Original Research Paper Dr. Prashanth Adiga MBBS , MS Gen Surgery , MCH (urology Assistant Professor Department Of Urology X 45GJRA - GLOBAL JOURNAL FOR RESEARCH ANALYSIS Surgery INTRODUCTION : Benign Prostate Hyperplasia is a common disease in adult men and its incidence is age related. Prevalence of BPH is approximately 25% in men aged 40 to 49 years, 50% in men aged 50 to 59 years and 80% in men aged 70 to 79 years. 1 Renal failure and symptomatic benign prostatic hyperplasia (BPH) are two common health problems, they usually co-exist in 5.9–13.6% of the male population over 50 years of age. TURP remains the gold standard surgical procedure for treatment of these cases. However, patients in renal failure have an increased risk for complications after TURP compared with patients with normal renal function, so we wanted to study the treatment outcome and complications associated with its management. The purpose of this study was to determine the incidence of renal failure associated with BPH , effect of TURP in the morbilidity and mortality of patients with renal failure. MATERIALS AND METHODS: Prospective study from October 2017 to November 2019 Setting : Govt. Stanley Medical college and Hospital, Chennai, This is a clinical study of 80 cases of Benign prostatic hyperplasia in normal and in patients with non dialysis requiring renal failure who underwent RESULTS: Once the serum creatinine values stabilized, the readings were recorded. Out of 40 patients who presented with elevated renal parameters, (patient with s.creatinine more than 1.3mg/dl ) ten patients subsequently showed fall in serum creatinine below 1.3, hence were considered along with normal patients in group 1. Because of this, the subsequent serum creatinine values of rest of 30 patients stabilized at a mean of 1.7 with a standard deviation of 0.3. Interestingly patients whose serum creatinine which stabilized at a value of more than 1.3, some of them had coexistent diabetes, hypertension. This might be an explanation that these patients have developed preexisting renal disease which was worsened by their developing benign prostatic hyperplasia in group 1, out of 30 patients, three people had bleeding, one had retention, one perioperative death due to myocardial infarction was recorded, one patient had infection. In all the patients with bleeding as complication, blood transfusion was given. Whereas in group 2, two people had bleeding out of 40 patients studied. ( 8% compared to 20% in group 1). CONCLUSION: The incidence of associated with benign prostatic hyperplasia in our study was about 12.5%. . ABSTRACT KEYWORDS : Benign Prostate , Turp , Renal Failure VOLUME-9, ISSUE-2, FEBRUARY-2020 • PRINT ISSN No. 2277 - 8160 • DOI : 10.36106/gjra 46 X GJRA - GLOBAL JOURNAL FOR RESEARCH ANALYSIS were recorded. Out of 40 patients who presented with elevated renal parameters, (patient with s.creatinine more than 1.3mg/dl ) ten patients subsequently showed fall in serum creatinine below 1.3, hence were considered along with normal patients in group 1. Because of this, the subsequent serum creatinine values of rest of 30 patients stabilized at a mean of 1.7 with a standard deviation of 0.3. Interestingly patients whose serum creatinine which stabilized at a value of more than 1.3, some of them had coexistent diabetes, hypertension. This might be an explanation that these patients have developed preexisting renal disease which was worsened by their developing benign prostatic hyperplasia in group 1, out of 30 patients, three people had bleeding, one had retention, one perioperative death due to myocardial infarction was recorded, one patient had infection. In all the patients with bleeding as complication, blood transfusion was given. Whereas in group 2, two people had bleeding out of 40 patients studied. ( 8% compared to 20% in group 1). When we taken retention, three people have developed in group 2. In case of infection, none had developed, compared to one patient in renal failure group. Death was not noted in group 2, whereas one recorded in group1 fall in serum creatinine between the time of presentation and post operative period, was signicant. This implies that Transurethral resection has made a positive outcome in this group of patients. DISCUSSION But, the European Association of Urology Guidelines on benign prostatic hyperplasia (2004) and the nephrology- focused NICE (National Institute for Health and Clinical Excellence) guidelines advocated measuring serum creatinine levels in all patients. This is relied on the fact, that bladder outlet obstruction due to benign prostatic enlargement can cause hydronephrosis and renal failure.23 Patients with benign prostatic enlargement and renal insufciency have relatively higher postoperative complicat ions (25% complication rate compared with 17% for patients without renal failure) and mortality goes up to sixfold than those with normal renal function.37,38, 45 Estimated glomerular ltration rate (eGFR) is a much more reliable measure to dene chronic kidney disease and is better than simple serum creatinine measurement. a cross-sectional survey in Spain of 2,000 randomly sampled men who were 50 years or older showed a 2.4% prevalence of self-reported renal failure related to a prostate condition (9% reported renal failure from any cause).63,9 Another study21 showed that men presenting for prostate surgery had a 7.7% prevalence of renal failure compared to a 3.7% prevalence in age matched men presenting for nonprostate surgery CONCLUSION The incidence of renal failure associated with benign prostatic hyperplasia in our study was about 12.5%. if intervention done early the renal failure can be reversed REFERENCES 1. 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Transurethral prostatectomy: immediate and postoperative complications. A cooperative study of 13 participating institutions evaluating 3,885 patients. J Urol. 1989 Feb; 141(2): p. 243-247 8. Roehrborn CG. BPH progression: concept and key learning from MTOPS, ALTESS, COMBAT, and ALF-ONE. BJU Int. 2008 Mar; 101 Suppl 3: p. 17-21. 47. Koch WF, Debruyne FM,. The outcome of renal ultrasound in the assessment of 556 consecutive patients with benign prostatic hyperplasia. J Urol. 1996 Jan; 155(1): p. 186-189 9. Sutaria PM, Staskin DR. Hydronephrosis and renal deterioration in the elderly due to abnormalities of the lower urinary tract and ureterovesical junction. Int Urol Nephrol. 2000; 32(1): p. 119-126. 10. Kojima M, Inui E, Ochiai A, Naya Y, Ukimura O, Watanabe H. Noninvasive quantitative estimation of infravesical obstruction using ultrasonic measurement of bladder weight. J Urol. 1997 Feb; 157(2): p. 476-479. VOLUME-9, ISSUE-2, FEBRUARY-2020 • PRINT ISSN No. 2277 - 8160 • DOI : 10.36106/gjra S. creat Mean N Std.Dev SE P value Per op 1.7 40 0.237 0.067 P=o.o46 6 weeks 1.5 40 0.271 0.057