Urodynamic Predictive Factors for Surgical Treatment Outcome of Benign Prostatic Hyperplasia

Lee, Il Kang; Hong, Sung Joo; Lee, Min Sung

Abstract

PURPOSE: Transurethral prostatectomy(TURP) or open prostatectomy were considered as standard treatments for benign prostatic hyperplasia(BPH), but these treatments showed high morbidity and mortality. We searched urodynamic predictive factors for successful surgical outcome to select patients who would benefit from prostatectomy pre-operatively. MATERIALS AND METHODS: Retrospectively, we reviewed preoperative urodynamic findings of 114 patients with BPH undergoing TURP(104cases) or open prostatectomy(10cases). RESULTS: In the follow-up period of 1 month to 19 months, a strict successes were achieved in 83 patients(73%). On analysis of the success rate, 4 favorable urodynamic factors and 8 unfavorable urodynamic factors were noted. 4 favorable factors were as follows; maximal flow rate<10ml/sec, compressive flow pattern, prostatic urethral length >6cm and presence of peak elevation on prostatic urethra pressure. 8 unfavorable factors were as follow; intermittent or normal flow pattern, prostatic urethral length<4cm, maximal detrusor pressure<10cmH2O, maximal bladder capacity<250ml, maximal urethral pressure >100cmH2O, prostatic pressure area <70cm cmH2O, non-obstructive pattern on Abrams-Griffiths nomogram and detrusor pressure at maximal flow rate <50cmH2O. CONCLUSIONS: Patients with more than 1 unfavorable urodynamic factor should be investigated carefully before surgery and be treated with other non-invasive treatment for BPH. The presence of 2 favorable urodynamic factors without unfavorable factor will usually predict the best surgical outcome.