Abstract
Background
Patients with benign prostatic hyperplasia (BPH) suffering from hypocontractile detrusor were generally regarded unsuitable for surgery. This prospective study is to evaluate the efficacy of transurethral resection of the prostate (TURP) on BPH patients diagnosed detrusor hypocontractility on urodynamic study (UDs).
Methods
Twenty patients were included in the study with mean age of 74.20 ± 7.93 years (range: 57–88). Outcomes were determined by patients’ self-assessment questionnaires, International Prostate Symptom Score (IPSS) and Quality of Life (QoL), and UDs parameters including maximum uroflow rate (Qmax), postvoid urine volume (PVR), bladder compliance, maximal cystometric capacity (MCC), and maximum detrusor pressure (Pdetmax).
Results
Median follow-up duration was 12 months (range: 10–16). After TURP, IPSS/QoL, Qmax, PVR, and Pdetmax were significantly improved and there were no significant differences with regard to bladder compliance and MCC.
Conclusion
UDs may play a very limited role in detecting bladder outlet obstruction (BOO) in BPH patients with hypocontractile detrusor. TURP may obtain a promising effect on such patients with unidentified BOO. These patients should not be arbitrarily excluded from surgical indications simply based on UDs findings.
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References
Abarbanel J, Marcus EL (2007) Impaired detrusor contractility in community-dwelling elderly presenting with lower urinary tract symptoms. Urology 69:436–440
Robertson AS, Griffiths C, Neal DE (1996) Conventional urodynamics and ambulatory monitoring in the definition and management of bladder outflow obstruction. J Urol 155:506–511
Javle P, Jenkins SA, Machin DG et al (1998) Grading of benign prostatic obstruction can predict the outcome of transurethral prostatectomy. J Urol 160:1713–1717
Van Venrooij GE, Boon TA, de Gier RPE (1995) International prostate symptom score and quality of life assessment versus urodynamic parameters in males with benign prostatic hyperplasia symptoms. J Urol 153:1516–1519
Gotoh M, Yoshikawa Y, Kondo AS (1999) Prognostic value of pressure-flow study in surgical treatment of benign prostatic obstruction. World J Urol 17:274–278
Van Mastrigt R, Rollema HJ (1992) The prognostic value of bladder contractility in transurethral resection of the prostate. J Urol 148:1856–1860
Machino R, Kakizaki H, Ameda K (2002) Detrusor instability with equivocal obstruction. A predictor of unfavorable symptomatic outcomes after transurethral prostatectomy. Neurourol Urodyn 21:444–449
Schafer W, Abrams P, Liao L (2002) Good urodynamic practices: uroflowmetry, filling cystometry and pressure-flow studies. Neurourol Urodyn 21:267–274
Abrams P (1994) In support of pressure-flow studies for evaluating men with lower urinary tract symptoms. Urology 44:153–155
Han DH, Jeong YS, Choo MS et al (2008) The efficacy of transurethral resection of the prostate in the patients with weak bladder contractility index. Urology 71(4):657–661
Abrams P, Cardozo L, Fall M (2002) The standardisation of terminology of lower urinary tract function: report from the standardisation sub-committee of the international continence society. Neurourol Urodyn 21:167–178
Fusco F, Groutz A, Blaivas JG (2001) Videourodynamic studies in men with lower urinary tract symptoms: a comparison of community based versus referral urological practices. J Urol 166:910–913
Thomas AW, Cannon A, Bartlett E (2005) The natural history of lower urinary tract dysfunction in men: minimum 10-year urodynamic follow-up of untreated detrusor underactivity. BJU Int 96:1295–1300
Belenky A, Abarbanel Y, Cohen M (2003) Detrusor resistive index evaluated by Doppler ultrasonography as a potential indicator of bladder outlet obstruction. Urology 62:647–650
De la Rosette JJM, Alivizatos G, Madersbacher S et al (2001) EAU guidelines on benign prostatic hyperplasia (BPH). Eur Urol 40:256–263
Madersbacher S (2004) Urodynamics prior to prostatectomy: pro. Eur Urol 45:557–560
Rischmann P (2004) Urodynamics prior to prostatectomy: con. Eur Urol 45:561–563
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Ou, R., Pan, C., Chen, H. et al. Urodynamically diagnosed detrusor hypocontractility: should transurethral resection of the prostate be contraindicated?. Int Urol Nephrol 44, 35–39 (2012). https://doi.org/10.1007/s11255-011-0010-2
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DOI: https://doi.org/10.1007/s11255-011-0010-2