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The natural history of lower urinary tract dysfunction in men: Minimum 10-year urodynamic followup of transurethral resection of prostate for bladder outlet obstruction

Thomas, Alun W.; Cannon, Andrea; Bartlett, Esther; Ellis-Jones, Julie; Abrams, Paul

Authors

Alun W. Thomas

Andrea Cannon

Esther Bartlett

Julie Ellis-Jones

Paul Abrams



Abstract

Purpose: Despite long-term symptomatic and uroflowmetry studies following transurethral prostate resection (TURP) there are sparse pressure flow data. Consequently there is minimal information to account for the long-term symptomatic failure and flow rate decrease seen with time following early improvements after surgery. Materials and Methods: Men older than 45 years who were investigated at our department between 1972 and 1986, diagnosed with bladder outlet obstruction and elected surgical intervention were invited for repeat symptomatic and urodynamic assessment. Identical methods were used, allowing direct comparison of results. Results: A total of 1,068 men were initially diagnosed with bladder outlet obstruction, of whom 428 (40%) died in the interim. Of the men who were followed 217 underwent TURP with a mean followup since surgery of 13.0 years. A significant, sustained decrease in the majority of symptoms and improvements of urodynamic parameters was seen. Long-term symptomatic failure and decreased flow rate were principally associated with detrusor under activity (DUA) rather than obstruction. Presentation predictive factors for the future development of DUA were decreased detrusor contractility and a lesser degree of obstruction. Conclusions: This unique long-term study provides valuable information on surgically treated bladder outlet obstruction. The association of long-term failure following surgery with DUA emphasizes the importance of pressure flow studies before repeat surgery. However, our faith in the long-term efficacy of TURP is justified. Copyright © 2005 by American Urological Association.

Citation

Thomas, A. W., Cannon, A., Bartlett, E., Ellis-Jones, J., & Abrams, P. (2005). The natural history of lower urinary tract dysfunction in men: Minimum 10-year urodynamic followup of transurethral resection of prostate for bladder outlet obstruction. Journal of Urology, The, 174(5), 1887-1891. https://doi.org/10.1097/01.ju.0000176740.76061.24

Journal Article Type Article
Publication Date Jan 1, 2005
Journal Journal of Urology
Print ISSN 0022-5347
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 174
Issue 5
Pages 1887-1891
DOI https://doi.org/10.1097/01.ju.0000176740.76061.24
Keywords lower urinary tract dysfunction, transurethral resection of prostate, bladder outlet obstruction
Public URL https://uwe-repository.worktribe.com/output/1046826