Features of detrusor function disorders in patients with dysuria in the long period after transurethral resection of the prostate

Abstract

BACKGROUND: Transurethral resection of the prostate (TURP) remains the “gold standard” for surgical treatment of patients with benign prostatic hyperplasia. At the same time, a significant number of patients continue to have urinary disorders after surgery. Dysuric disorders may be caused by detrusor dysfunction. AIM: The aim of the study was to determine the frequency, nature and clinical manifestations of detrusor dysfunction in patients with benign prostatic hyperplasia after TURP in the long-term postoperative period. MATERIALS AND METHODS: We examined 128 patients with benign prostatic hyperplasia aged from 56 to 87 years (mean 68.5 ± 7.1 years), who underwent TURP 12–36 months before inclusion in the study. All patients had urinary problems at the time of examination. All patients underwent a urological examination, which included a complex urodynamic study. The control group consisted of 48 patients with benign prostatic hyperplasia of comparable age, who did not have urinary disorders after TURP. RESULTS: Urodynamic signs of detrusor dysfunction were identified in 97 (75.8%) of 128 patients examined. Most often, isolated detrusor overactivity was detected (52.6%), less often a combination of detrusor over- and hypoactivity (25.8%) and isolated detrusor hypoactivity (21.7%). In patients with identified detrusor dysfunction, even before TURP, more pronounced urinary disorders were noted, which were characteristic of a certain type of detrusor dysfunction and persisted after surgical treatment. In patients with detrusor dysfunction, compared with patients from the control group, at the preoperative stage, urgency urinary incontinence, frequent urgency to urinate, diabetes mellitus, and a small volume of the prostate gland with the absence of intravesical protrusion were significantly more often detected. CONCLUSIONS: Detrusor dysfunction is an important cause of dysuria in patients with benign prostatic hyperplasia in the long-term period after TURP. It seems appropriate to conduct further research to clarify the indications for performing preoperative complex urodynamic study in patients with benign prostatic hyperplasia and lower urinary tract symptoms.