Evaluation of Persistent Lower Urinary Tract Symptoms after Transurethral Resection of Prostate

Nam, Jae Geun; Choi, Nak Gyeu

Abstract

PURPOSE: The urodynamic findings and subjective symptoms, in patients complaining of persistent lower urinary tract symptoms (LUTS) after a transurethral resection of the prostate (TURP) were evaluated. On the basis of these evaluations, the correlation, if any, between the urodynamic findings and the subjective symptoms was investigated.
MATERIALS AND METHODS
A total of 47 men, with persistent voiding dysfunction more than a year following TURP, were evaluated using the international prostate symptom score (IPSS) and multichannel urodynamics. The patients were classified into three groups: obstructed (<10ml/sec), equivocal (10-15ml/sec) and unobstructed (>15ml/sec), according to their Abrams-Griffiths nomogram.
RESULTS
From the urodynamic study, after the TURP, 6, 7 and 34 patients were placed into the obstructed, equivocal and unobstructed groups, respectively. There were no significant differences in the IPSS, and irritative and obstructive voiding symptom scores, between the obstructed, equivocal and unobstructed groups. The average IPSS in LUTS, with, and without, detrusor instability were 17.2+/-8.4 and 16.3+/-2.6 (p>0.05). The Qmax, detrusor pressure and residual urine volume, of the unobstructed group was significantly higher than those of the other two groups.
CONCLUSIONS
Detrusor instability was the most frequent urodynamic finding in the patients complaining of persistent LUTS after TURP, but it is necessary to perform the urodynamics to decide on the appropriate treatment; either medical treatment, for the detrusor instability without a bladder outlet obstruction, or surgical removal of a bladder outlet obstruction. The symptoms were not reliable in predicting the urodynamic findings in regard to an obstruction and detrusor instability.