Behaviour of bladder after TURP in underactive detrusor patients

Behaviour of bladder after TURP

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 LUTS 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.

Material and 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 preoperative evaluations and urodynamics assessments before and after TURP. We compared maximum flow rate (Qmax), International Prostate Symptom Score (IPSS), postvoid 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.

Key words – Detrusor Underactivity, TURP, Bladder contractility Index