Characterization of men with lower urinary tract dysfunction after surgical management of benign prostatic obstruction
Objective: To characterize the symptoms and urodynamic findings of men with lower urinary tract dysfunction after a transurethral resection of the prostate (TURP).
Materials and Methods: A total of 123 consecutive men with lower urinary tract dysfunction after surgical treatment for lower urinary tract symptoms (LUTS) were analyzed. Men with prostate cancer, stricture, multiple TURPs, radical prostatectomy or prostate cancer treatment were excluded. Parameters assessed by urodynamics included bladder capacity, detrusor contractibility, pressure flow study, and post void residual. Analysis of the variance was used to compare outcomes of urodynamic parameters between the primary diagnoses.
Results: Mean age at TURP was 68 years (range 39 to 88). Symptoms included frequency (68%), nocturia (53%), urgency (44%), and retention requiring catheterization (17%). A total of 72 men (59%) were diagnosed with bladder outlet obstruction (BOO), 30 (24%) with impaired detrusor contractility (DU), and 21 (17%) with detrusor over activity (DO). Among these groups, there was no difference in duration of recurrent symptoms, AUA symptom score, Quality of Life score, or prostate size. Maximum flow was significantly less and post-void residual significantly greater in both BOO and DU groups. Bladder capacity was significantly higher in DU.
Conclusions: In the modern era, bladder outlet obstruction was the most common cause of recurrent lower urinary tract dysfunction after surgical management of BPO.
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