Document Detail


The natural history of lower urinary tract dysfunction in men: the influence of detrusor underactivity on the outcome after transurethral resection of the prostate with a minimum 10-year urodynamic follow-up.
MedLine Citation:
PMID:  15049984     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To assess the long-term outcome of the efficacy of transurethral resection of the prostate (TURP) in men with detrusor underactivity (DUA), a cause of lower urinary tract symptoms (LUTS) in a significant minority of men. PATIENTS AND METHODS: Neurologically intact men with LUTS, who were investigated in our department between 1972 and 1986, diagnosed with DUA and who underwent surgical intervention, were invited for a repeat symptomatic and urodynamic assessment. Identical methods were used, allowing direct comparison of the results. RESULTS: In all, 224 men were initially diagnosed with DUA; 87 (39%) of these died in the interim and 22 followed had a TURP, with a mean follow-up since surgery of 11.3 years. There were no significantly sustained reductions in any symptoms. There was a small but significant reduction of questionable clinical significance in the bladder outlet obstruction index, but this did not translate into an improved flow rate. Comparison with 58 age-matched patients with DUA who remained untreated showed no significant advantage of surgical intervention in the long-term; on the contrary, there was more chronic retention in those who had had surgery. CONCLUSIONS: There are no long-term symptomatic or urodynamic gains from TURP in men shown to have DUA. The results of TURP in men with DUA are important, as urologists who surgically treat patients based on the symptoms and uroflowmetry alone will do so in a significant minority of men with DUA. These results strengthen the argument for a routine preoperative urodynamic assessment.
Authors:
A W Thomas; A Cannon; E Bartlett; J Ellis-Jones; P Abrams
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Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  BJU international     Volume:  93     ISSN:  1464-4096     ISO Abbreviation:  BJU Int.     Publication Date:  2004 Apr 
Date Detail:
Created Date:  2004-03-30     Completed Date:  2004-05-04     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  100886721     Medline TA:  BJU Int     Country:  England    
Other Details:
Languages:  eng     Pagination:  745-50     Citation Subset:  IM    
Affiliation:
Bristol Urological Institute, Southmead Hospital, Bristol, UK.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Algorithms
Follow-Up Studies
Humans
Male
Middle Aged
Prostatic Hyperplasia / complications,  physiopathology*,  surgery
Transurethral Resection of Prostate / standards*
Treatment Outcome
Urinary Bladder Diseases / complications,  physiopathology*
Urinary Catheterization
Urinary Retention / etiology,  physiopathology*
Urodynamics
Comments/Corrections
Comment In:
J Urol. 2005 Aug;174(2):608   [PMID:  16006916 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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