The Outcome of Prostatectomy on Chronic Retention of Urine

Abstract

A total of 68 men with bladder outflow obstruction and chronic retention (residual urine greater than 300ml.) underwent investigation before and after prostatectomy with medium fill cystometry and natural fill long-term bladder pressure monitoring. Postoperatively, upper tract dilatation (present in 28 men preoperatively) resolved in all but 2 men and serum creatinine levels improved significantly. Irritative and obstructive symptom scores improved postoperatively (p <0.00006), although 17% of the men still had significant symptoms. Residual urine volumes decreased and flow rates improved (p <0.00006) but 32% of the men still had a residual urine of greater than 200ml. Urodynamic parameters improved during medium fill cystometry and long-term monitoring. The main risk factors for upper tract dilatation are a pressure increase during bladder filling on conventional cystometry and the frequency of phasic detrusor activity during long-term monitoring, and they decreased postoperatively.