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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

Thomas, A. W.; Cannon, A.; Bartlett, E.; Ellis-Jones, Julie; Abrams, P.

Authors

A. W. Thomas

A. Cannon

E. Bartlett

Julie Ellis-Jones

P. Abrams



Abstract

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.

Citation

Thomas, A. W., Cannon, A., Bartlett, E., Ellis-Jones, J., & Abrams, P. (2004). 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. BJU International, 93(6), 745-750. https://doi.org/10.1111/j.1464-410X.2003.04719.x

Journal Article Type Article
Publication Date Apr 1, 2004
Journal BJU International
Print ISSN 1464-4096
Publisher Wiley
Peer Reviewed Peer Reviewed
Volume 93
Issue 6
Pages 745-750
DOI https://doi.org/10.1111/j.1464-410X.2003.04719.x
Keywords detrusor underactivity, TURP, urodynamics, LUTS, natural history, BPH
Public URL https://uwe-repository.worktribe.com/output/1061516