Impact of detrusor underactivity on the outcomes of transurethral resection of prostate in patients with benign prostatic obstruction

Abstract

Objective To analyze the impact of detrusor underactivity(DU) on the outcomes of transurethral resection of prostate (TURP) in patients with benign prostatic obstruction(BPO). Methods A retrospective study was conducted in 157 BPO patients who underwent TURP from January 2013 to December 2016.Their ages ranged from 48 to 86 years with a mean age of 70 years. All patients underwent urodynamic study before surgery, bladder contraction index(BCI) ranged from 49.3 to 208.6, with a mean of 120.1. The patients were divided into two groups according to BCI. DU group(BCI 0.05 for each). The outcomes of TURP were assessed by the above mentioned parameters at 3 months postoperatively; IPSS、IPSS-S、IPSS-V were regarded as successful if they improved more than 50%, QOL was successful if it was improved more than 3, fQmax successful if it was improved 5ml/s.The change and successful improvement rates of the above mentioned parameters were compared between DU and non-DU group. Through receiver operating characteristic curve(ROC) analysis , patients were categorized into mild DU and severe DU group and compared the successful improvement rates between the two groups. Results Both DU group and non-DU group improved significantly in IPSS, IPSS-S, IPSS-V, QOL, fQmax, PVR at 3 months postoperatively(P 0.05 for each]. Conclusions Benign prostatic obstruction patients with DU can achieve improvement in both subjective and objective parameters after TURP, but patients without DU can get more improvement. BPO patients with severe DU patients show a worse improvement of the voiding symptom. Surgeons should have adequate communication with the patients and inform them of appropriate expectations. Key words: Benign prostatic obstruction; Transurethral resection of prostate; Urodynamics; Bladder contraction index; Detrusor underactivity