BEHAVIOR OF BLADDER AFTER TURP IN UNDERACTIVE DETRUSOR PATIENTS

Pranab Patnaik, Vikalap Gupta, S. Das
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Abstract

Objective: The gold standard therapy for benign prostatic obstruction is transurethral resection of the prostate (TURP). Because it improves outlet resistance, it may also be useful for individuals who have detrusor underactivity (DU) with lower urinary tract dysfunction that is refractory to medicinal therapy or in situations with a substantial residual urine volume. The objective of the current study was to assess the urodynamic behavior of the bladder following TURP in DU patients. Methods: This research examined and analyzed 41 individuals with DU (mean age 68.7 years). All these patients had a TURP for a suspected outlet blockage. All these patients had extensive pre-operative evaluations and urodynamics assessments before and after TURP. We compared maximum flow rate (Qmax), international prostate symptom score (IPSS), post-void residuals (PVR), quality of life (QoL) along with other urodynamic parameters assessing detrusor function like bladder contractility index (BCI), and detrusor pressure at Qmax (pdetQmax) pre- and post-TURP. Results: The average duration of follow-up of patients was 9.2 months. Following TURP, the mean IPSS and QoL improvement was statistically significant. Following TURP, there was also a substantial decrease in PVR while we observed an improvement in Qmax value. Even after TURP, there was no substantial change in total cystometric capacity, BCI, or pdetQmax index. Conclusion: DU may not be an absolute contraindication to TURP. Despite the presence of DU, the prognosis of TURP may be optimistic if the patients have evident bladder outlet obstruction. However, medically removing the blockage does not increase contractility, which is essential when evaluating and advising on TURP surgery.
逼尿肌功能不全患者做完排尿术后的膀胱表现
目的:良性前列腺梗阻的金标准疗法是经尿道前列腺切除术(TURP)。经尿道前列腺电切术(TURP)可改善尿道出口阻力,因此也适用于药物治疗难治的下尿路功能障碍(DU)患者或残余尿量较多的患者。本研究的目的是评估 DU 患者 TURP 术后膀胱的尿动力学表现:本研究对 41 名 DU 患者(平均年龄 68.7 岁)进行了检查和分析。所有这些患者都因怀疑出口堵塞而接受了 TURP 手术。所有这些患者在 TURP 前后都接受了广泛的术前评估和尿动力学评估。我们比较了TURP前后的最大尿流率(Qmax)、国际前列腺症状评分(IPSS)、排尿后残余物(PVR)、生活质量(QoL)以及其他评估逼尿肌功能的尿动力学参数,如膀胱收缩力指数(BCI)和Qmax时的逼尿肌压力(pdetQmax):患者的平均随访时间为 9.2 个月。结果:患者的平均随访时间为 9.2 个月。TURP 术后,患者的平均 IPSS 和 QoL 均有显著改善。行前列腺切除术后,PVR 也大幅下降,同时我们观察到 Qmax 值有所改善。即使在 TURP 术后,总膀胱容量、BCI 或 pdetQmax 指数也没有发生实质性变化:结论:DU 并非 TURP 的绝对禁忌症。结论:DU 并非 TURP 的绝对禁忌症。尽管存在 DU,但如果患者有明显的膀胱出口梗阻,TURP 的预后可能会比较乐观。然而,药物去除阻塞并不能增加收缩力,而这对于评估 TURP 手术并提出建议至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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