Effect of Transurethral Resection of the Prostate on Urodynamic Parameters in Patients with Benign Prostatic Enlargement with Upper Urinary Tract Dilatation-Reference-Cited by-同舟云学术

Effect of Transurethral Resection of the Prostate on Urodynamic Parameters in Patients with Benign Prostatic Enlargement with Upper Urinary Tract Dilatation

Published:2021 Issue:9-10 Volume:105 Page:846-851
ISSN:0042-1138
Container-title:Urologia Internationalis
language:en
Short-container-title:Urol Int

Author:

Sahu Subhranshu,Parmar Kalpesh,Kumar Santosh,Tyagi Shantanu,Mandal Subhajit,Devana Sudheer Kumar,Sharma Aditya Prakash,Bora Girdhar,Mavuduru Ravi Mohan

Abstract

Objective: To evaluate the urodynamic outcomes of transurethral resection of the prostate (TURP) in patients of benign prostatic enlargement (BPE) with upper urinary tract dilatation and correlate with International Prostate Symptoms Score (I-PSS). Methods: In this prospective study, patients of BPE with upper urinary tract dilatation from July 2017 to June 2019 were enrolled. At presentation, detailed I-PSS, ultrasonography abdomen, serum creatinine, and serum PSA were recorded. All the patients were catheterized and observed for postobstructive diuresis. At 4 weeks, repeat ultrasound and serum creatinine were recorded. Urodynamic study (UDS) was performed after ensuring sterile urine culture. Patients underwent TURP as per the standard technique. A repeat UDS was performed after 3 months, and analysis was done. Results: Forty-four patients were enrolled of which data of 37 patients were analyzed. In the filling phase of the UDS, there was a significant decrease in detrusor pressure at the end filling phase from 27 to 9.0 cm H2O after TURP. Maximum cystometric capacity and bladder compliance significantly improved at 3 months following surgery. In the voiding phase, peak flow rate showed a significant increase, postvoid residual urine volume significantly decreased, and peak detrusor pressure marginally decreased following TURP. The I-PSS decreased from 20 ± 8 to 5 ± 6 following TURP. Conclusion: High detrusor pressure and reduced compliance is a risk factor for upper urinary tract dilatation. Changes in the bladder dynamics and resolution of hydronephrosis following TURP reflected in the changes in urodynamic parameters and I-PSS.

Publisher

S. Karger AG

Subject

Urology

Reference19 articles.

1. Rule AD, Jacobson DJ, Roberts RO, Girman CJ, McGree ME, Lieber MM, et al. The association between benign prostatic hyperplasia and chronic kidney disease in community-dwelling men. Kidney Int. 2005;67(6):2376–82.

2. Rodrigues P, Lucon AM, Freire GC, Arap S. Urodynamic pressure flow studies can predict the clinical outcome after transurethral prostatic resection. J Urol. 2001;165(2):499–502.

3. Gosling JA, Kung LS, Dixon JS, Horan P, Whitbeck C, Levin RM. Correlation between the structure and function of the rabbit urinary bladder following partial outlet obstruction. J Urol. 2000;163(4):1349–56.

4. Abrams P. Bladder outlet obstruction index, bladder contractility index and bladder voiding efficiency: three simple indices to define bladder voiding function. BJU Int. 1999;84(1):14–5.

5. Lim CS, Abrams P. The Abrams-Griffiths nomogram. World J Urol. 1995;13(1):34–9.