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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

2005; Lippincott Williams & Wilkins; Volume: 174; Issue: 5 Linguagem: Inglês

10.1097/01.ju.0000176740.76061.24

1527-3792

Alun Thomas, Andréa Cannon, Esther Bartlett, Julie Ellis‐Jones, Paul Abrams,

Pelvic floor disorders treatments

No AccessJournal of UrologyAdult Urology: Voiding Dysfunction1 Nov 2005THE NATURAL HISTORY OF LOWER URINARY TRACT DYSFUNCTION IN MEN: MINIMUM 10-YEAR URODYNAMIC FOLLOWUP OF TRANSURETHRAL RESECTION OF PROSTATE FOR BLADDER OUTLET OBSTRUCTION ALUN W. THOMAS, ANDREA CANNON, ESTHER BARTLETT, JULIE ELLIS-JONES, and PAUL ABRAMS ALUN W. THOMASALUN W. THOMAS More articles by this author , ANDREA CANNONANDREA CANNON More articles by this author , ESTHER BARTLETTESTHER BARTLETT More articles by this author , JULIE ELLIS-JONESJULIE ELLIS-JONES More articles by this author , and PAUL ABRAMSPAUL ABRAMS More articles by this author View All Author Informationhttps://doi.org/10.1097/01.ju.0000176740.76061.24AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail 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. References 1 : The urodynamic changes following prostatectomy.. Urol Int1979; 33: 181. Google Scholar 2 : Prostatectomy or conservative management in the treatment of benign prostatic hypertrophy?. Br J Urol1988; 61: 432. Google Scholar 3 : Outcome of elective prostatectomy. BMJ1989; 299: 762. Google Scholar 4 : Symptom analysis and uroflowmetry 7 years after transurethral resection of the prostate.. J Urol1989; 142: 1251. 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Link, Google Scholar From the Bristol Urological Institute, Bristol, United Kingdom© 2005 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byKaplan S (2017) Re: Analysis of Risk Factors Leading to Postoperative Urethral Stricture and Bladder Neck Contracture following Transurethral Resection of ProstateJournal of Urology, VOL. 198, NO. 4, (720-721), Online publication date: 1-Oct-2017.Winters J, Dmochowski R, Goldman H, Herndon C, Kobashi K, Kraus S, Lemack G, Nitti V, Rovner E and Wein A (2012) Urodynamic Studies in Adults: AUA/SUFU GuidelineJournal of Urology, VOL. 188, NO. 6S, (2464-2472), Online publication date: 1-Dec-2012.Seki N, Nomura H, Yamaguchi A and Naito S (2008) Effects of Photoselective Vaporization of the Prostate on Urodynamics in Patients With Benign Prostatic HyperplasiaJournal of Urology, VOL. 180, NO. 3, (1024-1029), Online publication date: 1-Sep-2008.Sajeel M, Harding C, Robson W, Drinnan M, Griffiths C and Pickard R (2007) Categorization of Obstruction Using Noninvasive Pressure Flow Measurements: Sensitivity to Change Following ProstatectomyJournal of Urology, VOL. 178, NO. 3, (996-1001), Online publication date: 1-Sep-2007.Wein A (2018) Voiding Function and Dysfunction, Bladder Physiology and Pharmacology, and Female UrologyJournal of Urology, VOL. 176, NO. 1, (210-214), Online publication date: 1-Jul-2006. Volume 174Issue 5November 2005Page: 1887-1891 Advertisement Copyright & Permissions© 2005 by American Urological Association, Inc.Keywordsurodynamicstransurethral resection of prostatebladderbladder neck obstructionnatural historyMetricsAuthor Information ALUN W. THOMAS More articles by this author ANDREA CANNON More articles by this author ESTHER BARTLETT More articles by this author JULIE ELLIS-JONES More articles by this author PAUL ABRAMS More articles by this author Expand All Advertisement PDF downloadLoading ...