The Influence of TURP on Detrusor Instability in Patients with BPH: A Clinical and Urodynamic Analysis

Lee, Jong Chan; Yang, Sang Kuk; Kim, Hong Sup

Abstract

PURPOSE: Detrusor instability (DI) is a main cause of persistent voiding difficulty after TURP in patients with benign prostatic hyperplasia (BPH). So we retrospectively estimated the effect of TURP in BPH patients with DI.
MATERIALS AND METHODS
Of the 81 patients who had undergone TURP due to prostatism, 35 patients with BPH were followed at 3 weeks and 6 months postoperatively (21 without DI cases vs. 14 with DI; 6 persistent DI, 7 resolved DI, 1 missing case at 3 weeks and 4 persistent DI, 7 resolved DI, 2 missing cases at 6 months). We compared each group using symptom score (IPSS) and urodynamic parameters.
RESULTS
Each irritative and obstructive symptoms were significantly improved in both group (p<0.05). The maximal flow rate (from 12.2 to 25.4ml/sec), average flow rate (from 8.9 to 15.2ml/ sec), residual urine volume (from 135.9 to 39.1ml) in patients without DI and maximal bladder volume (from 150.0 to 203.7ml), maximal flow rate (from 12.5 to 18.6ml/sec), residual urine volume (from 65.7 to 26.0ml) in patients with DI were improved significantly (p<0.05) after TURP, but other parameters were not improved (p>0.05). There were no significant differences in all parameters between 3 weeks and 6 months postoperative period (p>0.05). The amplitude of improvement had no significant difference between two group. There were no significant differences in IPSS and urodynamic parameters between persistent and resolved DI group.
CONCLUSION
We suggest that TURP is good therapeutic option even in BPH patients with DI at short term postoperative period, but attempt to predict which patients would have persistent DI following TURP was failed.