The Urodynamic Findings of Male Patients with LUTS and the Effects of the Pre-operative Parameters on the Outcome of Transurethral Resection of the Prostate

Im, Jae Gyun; Kim, Joon Chul; Hwang, Tae Kon

Abstract

PURPOSE: We tried to find out the urodynamic features of the male patients suffering with lower urinary tract symptoms (LUTS) and we wanted to know the effects of the preoperative parameters on the outcome of transurethral resection of the prostate (TURP).
MATERIALS AND METHODS
One hundred ninety four patients who had LUTS and who had undergone urodynamic study were available for analysis. The history taking and physical examination, urinalysis, International Prostate Symptom Score (IPSS), transrectal ultrasonography, serum prostate-specific antigen (PSA) level check and urodynamic study were performed for all the patients. Also, the postoperative IPSS and satisfaction level were accessed for the patients who had undergone TURP for bladder outlet obstruction (BOO), and the preoperative factors such as age, prostate volume, PSA and urodynamic findings were analyzed.
RESULTS
For the total 194 patients, there were 123 BOO patients (63.4%), 62 detrusor overactivity patients (13.4%) and 19 detrusor underactivity patients (9.8%). For the patients who had undergone TURP, the IPSS was decreased from a preoperative value of 20.5 to a postoperative value of 9.0. We divided the patients into two groups in accordance with the level of satisfaction after the operation. Within the two groups, the dissatisfied group showed a preponderance of preoperative detrusor overactivity. When performing IPSS, both groups showed a decreased score with each having a different range: from 20.8 to 6.1 in the satisfied group, and from 23.2 to 14.8 in the dissatisfied group.
CONCLUSIONS
BOO is most common cause among the male patients who have LUTS and who are more than 50 years old, but other causes should be considered. Moreover, if BOO accompanies detrusor overactivity, the importance of the preoperative urodynamic findings deserves emphasis, and it will help to predict the results of performing TURP.