The Natural History of Lower Urinary Tract Dysfunction in Men: Minimum 10-Year Urodynamic Followup of Transurethral Resection of Prostate for Bladder Outlet Obstruction

2006 ◽  
Vol 2006 ◽  
pp. 119-120
Author(s):  
C.G. Roehrborn
2016 ◽  
Vol 15 (3) ◽  
pp. e996
Author(s):  
A. Hashemi Gheinani ◽  
F.C. Burkhard ◽  
H. Rehrauer ◽  
C. Aquino Fournier ◽  
I. Keller ◽  
...  

1970 ◽  
Vol 8 (2) ◽  
pp. 203-207 ◽  
Author(s):  
B Shrestha ◽  
JL Baidya

Background: Transurethral resection of the prostate underwent significant technical improvements during the last decades, with major impact on the incidence of intra and postoperative complications. Objectives: The objective of the study was to analyse the early complications and to predict immediate outcomes of transurethral resection of prostate (TURP) in a single tertiary care institute. Materials and methods: We prospectively evaluated 100 patients undergoing transurethral resection of prostate at B and B Hospital, Gwarko, Lalitpur, Nepal, from August 2008 till April 2009. Case records containing 32 variables concerning preoperative status, operative details, complications and immediate outcome were recorded for each patient. Results: The cumulative short-term postoperative significant morbidity was 10% and the peroperative morbidity was 6%. The most relevant postoperative complication was failure to void (24%). Among significant postoperative morbidities, surgical revision had to be performed in two patients (2%), open prostatectomy in one patient, transurethral resection (TUR) syndrome in 5% and significant urinary tract infection in 2%. Among significant intra operative morbidity, we had one case with bladder perforation, significant cardiac arrhythmia requiring prompt attention in 4% and TUR syndrome during resection in 1%. We did not have any mortality related to the procedure during the study period. The resected tissue averaged 25.67gm. Incidental carcinoma of the prostate was diagnosed by histological examination in 4% of patients. Urine peak flow rate (Q-max) increased to 12.88ml per second from 9.24ml per second and average fl ow rate increased to 7.36 ml per second from 5.03 ml per second. The postoperative mean residual urine measured by ultrasound decreased to 28.46ml from preoperative 86.59 ml. Conclusions: TURP has, for decades, been the standard surgical therapy for lower urinary tract symptoms secondary to benign prostatic hyperplasia though significant morbidities can be associated with the procedure. Meticulous preoperative workup and proper selection of the patients for the procedure significantly improve the outcome after transurethral resection of the prostate. Key words: TURP ( Transurethral resection of prostate); LUTS ( Lower urinary tract symptoms); BOO (Bladder outlet obstruction) DOI: 10.3126/kumj.v8i2.3559 Kathmandu University Medical Journal (2010), Vol. 8, No. 2, Issue 30, 203-207


2016 ◽  
Vol 10 (3) ◽  
pp. 140-144 ◽  
Author(s):  
Evert Baten ◽  
Koenraad van Renterghem

Objective: To investigate elevated or rising prostate specific antigen (PSA) as a marker for bladder outlet obstruction (BOO) in patients with minor lower urinary tract symptoms (LUTS) and without prostate cancer. Materials and Methods: One hundred and five consecutive patients were prospectively analyzed between 2005 and 2013. All patients were referred to the principal investigator by their general practitioner as a result of an elevated and/or rising PSA. Only patients with minor LUTS [International Prostate Symptom Score (I-PSS) 0-19] and without suspicion for prostate cancer were included. All patients had BOO, shown by full urodynamics, and underwent transurethral resection of the prostate. The resected tissue was histologically examined and PSA and I-PSS were evaluated after 3, 6 and 12 months and later on yearly. Results: Mean pre-operative PSA and I-PSS values were 8.8 ng/ml and 11.1, respectively. The mean detrusor pressure at maximum flow was 93.6 cmH2O. The mean resected volume was 52 g and the mean prostate biopsy rate was 1.8. Eighty-three of 105 patients (79%) had no malignancy and were diagnosed with BOO due to benign prostate hyperplasia (subgroup 1). Their mean PSA decreased from 9.2 to 0.7 ng/ml and 0.9 ng/ml after 6 and 12 months post-operation, respectively. The mean I-PSS declined from 11 to 3 after 6 and 12 months. Sixteen of 105 patients (15%) were treated for prostate cancer (subgroup 2). Radical prostatectomy was performed in 11 patients, brachytherapy in 3 patients and external beam radiotherapy in 2 patients. Six of 105 patients (5.7%) had active surveillance (subgroup 3). Conclusion: BOO can cause an elevated or rising PSA in patients with minor LUTS and negative screening for prostate cancer. Transurethral resection of the prostate is an adequate treatment for these patients.


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