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Jung, Hwang, and Kim: The Outcome and Satisfaction of Patients with Lower Urinary Tract Symptoms /Benign Prostatic Hyperplasia following Transurethral Resection of the Prostate according to Urodynamic Obstruction and the Bladder Function
Original Article
Korean Journal of Urology

Korean Journal of Urology 2007; 48(9): 965-970.

Published online: 30 September 2007

DOI: https://doi.org/10.4111/kju.2007.48.9.965

The Outcome and Satisfaction of Patients with Lower Urinary Tract Symptoms /Benign Prostatic Hyperplasia following Transurethral Resection of the Prostate according to Urodynamic Obstruction and the Bladder Function

Yun Seok Jung, Tae-Kon Hwang, Joon Chul Kim

Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Korea.

Corresponding author (kjc@catholic.ac.kr)

Received 27 April 2007       Accepted 13 July 2007

Copyright © 2007 The Korean Urological Association

Abstract

Purpose

We compared the clinical and urodynamic findings of patients suffering with lower urinary tract symptoms (LUTS)/benign prostatic hyperplasia (BPH) and who underwent transurethral resection of the prostate, and we tried to determine the effect of urodynamical obstruction and the bladder function on the result of this operation.

Materials and Methods

101 patients with LUTS/BPH were categorized in four groups based on the findings of the preoperative urodynamic study: 15 (14.8%) patients without bladder outlet obstruction [(BOO (-)], 50 (49.5%), patients with BOO [(BOO (+)], 12 patients (11.8%) with BOO and with detrusor underactivity (BOO+DU), and 24 patients (23.7%) with BOO and with detrusor overactivity (BOO+DO). The outcomes and satisfaction were analyzed by the changes of the International Prostate Symptom Score (IPSS) and the quality of life (QoL) index before and after transurethral resection of the prostate (TURP), respectively.

Results

The Qmax was significantly high and residual urine was significantly low in group BOO (-). The PdetQmax was significantly high in group BOO (+) and also in the BOO+DO group. In group BOO (-), the decrease of the total IPSS was smaller than that noted in the other groups. There were significant decreases of the IPSS after TURP in groups BOO (+), BOO+DU and BOO+DO each voiding and storage subscore were decreased,but in group BOO+DO, the improvement was not as much as that in the other groups. The QoL was improved significantly in group BOO compared to the other groups.

Conclusions

Performing urodynamics preoperatively helps to predict the degree of symptom relief, and a higherbaseline BOO positively predicts the postoperative improvement of the IPSS and the QoL. The outcome of the BOO+DU group was satisfactory, but storage symptoms still existed for the BOO+DO group.

Keywords: Prostatic hyperplasia, Urodynamics, Urinary Bladder neck obstruction, Transurethral resection of prostate

Figures and Tables

Fig. 1
Change of the IPSS after TURP. IPSS: International Prostate Symptom score, TURP: transurethral resection of the prostate, BOO: bladder outlet obstruction, DU: detrusor underactivity, DO: detrusor overactivity, *: p<0.05 compared with preop.
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Fig. 2
Change of voiding (A) and the storage score (B) after TURP. IPSS: International Prostate Symptom score, TURP: transurethral resection of the prostate, BOO: bladder outlet obstruction, DU: detrusor underactivity, DO: detrusor overactivity, *: p<0.05 compared with preop.
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Fig. 3
Change of the QoL after TURP. QoL: quality of life, TURP: transurethral resection of the prostate, BOO: bladder outlet obstruction, DU: detrusor underactivity, DO: detrusor overactivity, *: p<0.05 compared with preop.
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Table 1
Preoperative clinical findings
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BOO: bladder outlet obstruction, DU: detrusor underactivity, DO: detrusor overactivity, IPSS: International Prostate Symptom Score, PSA: prostate-specific antigen, QoL: quality of life

Table 2
Preoperative urodynamic findings
kju-48-965-i002

BOO: bladder outlet obstruction, DU: detrusor underactivity, DO: detrusor overactivity, Qmax: peak flow rate, PdetQmax: detrusor pressure at maximun flow rate, *: p<0.05

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