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The Evolution of Detrusor Overactivity After Watchful Waiting, Medical Therapy and Surgery in Patients with Bladder Outlet Obstruction

2003; Lippincott Williams & Wilkins; Volume: 169; Issue: 2 Linguagem: Inglês

10.1016/s0022-5347(05)63949-3

1527-3792

Cosimo De Nunzio, Giorgio Franco, Andrea Rocchegiani, Francesco Iori, Costantino Leonardo, C Laurenti,

Pelvic floor disorders treatments

No AccessJournal of UrologyCLINICAL UROLOGY: Original Articles1 Feb 2003The Evolution of Detrusor Overactivity After Watchful Waiting, Medical Therapy and Surgery in Patients with Bladder Outlet Obstruction COSIMO de NUNZIO, GIORGIO FRANCO, ANDREA ROCCHEGIANI, FRANCESCO IORI, COSTANTINO LEONARDO, and CESARE LAURENTI COSIMO de NUNZIOCOSIMO de NUNZIO More articles by this author , GIORGIO FRANCOGIORGIO FRANCO More articles by this author , ANDREA ROCCHEGIANIANDREA ROCCHEGIANI More articles by this author , FRANCESCO IORIFRANCESCO IORI More articles by this author , COSTANTINO LEONARDOCOSTANTINO LEONARDO More articles by this author , and CESARE LAURENTICESARE LAURENTI More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)63949-3AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We analyzed the evolution of detrusor overactivity in patients with bladder outlet obstruction treated with either medical or surgical therapy or watchful waiting. Materials and Methods: Of 255 patients with symptomatic benign prostatic enlargement who completed the International Prostate Symptom Score and underwent full urodynamic investigation 161 presented with bladder outlet obstruction. Of the 161 men 101 were reevaluated with a second clinical evaluation and urodynamics 1 to 5 years (mean 2) after watchful waiting in 20, medical treatment (alfuzosin 20 and finasteride 16) in 36 and surgery (transurethral incision of the prostate 13 and prostatectomy 32) in 45. For statistical analysis Wilcoxon matched paired data and Kruskal Wallis tests were used as appropriate. Results: Overall detrusor overactivity was present in 53 patients (52%) at baseline and 41 (40%) at followup. Detrusor overactivity was present in 9 patients (45%) at baseline and 11 (55%) at followup in the watchful waiting group (p = 0.17); 7 (35%) at baseline and 6 (30%) at followup in the alfuzosin group (p = 0.37); 10 (62.5%) at baseline and 10 at followup in the finasteride group (p = 1); 6 (46%) at baseline and 4 (30%) at followup in the transurethral prostate incision group (p = 0.48); and 21 (68%) at baseline and 10 (31%) at followup in the prostatectomy group (p = 0.02). Conclusions: Detrusor overactivity is highly prevalent (52%) in patients with bladder outlet obstruction, and appears to persist for long periods when obstruction is left untreated or treated only with medical therapy. However, surgical treatment of bladder outlet obstruction, prostatectomy in particular, significantly reduces the incidence of detrusor overactivity and lessens the chance of its de novo appearance for up to 5 years. References 1 : Detrusor instability and bladder outlet obstruction. 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Bracci” Department of Urology, “La Sapienza” University of Rome, Rome, Italy© 2003 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byJiang Y, Lee C and Kuo H (2018) Urothelial Dysfunction, Suburothelial Inflammation and Altered Sensory Protein Expression in Men with Bladder Outlet Obstruction and Various Bladder Dysfunctions: Correlation with UrodynamicsJournal of Urology, VOL. 196, NO. 3, (831-837), Online publication date: 1-Sep-2016.Seki N, Nomura H, Yamaguchi A and Naito S (2018) 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.Abrams P, Kaplan S, De Koning Gans H and Millard R (2018) Safety and Tolerability of Tolterodine for the Treatment of Overactive Bladder in Men With Bladder Outlet ObstructionJournal of Urology, VOL. 175, NO. 3, (999-1004), Online publication date: 1-Mar-2006.GIANNANTONI A, MEARINI E, Di STASI S, MEARINI L, BINI V, PIZZIRUSSO G and PORENA M (2018) ASSESSMENT OF BLADDER AND URETHRAL SPHINCTER FUNCTION BEFORE AND AFTER RADICAL RETROPUBIC PROSTATECTOMYJournal of Urology, VOL. 171, NO. 4, (1563-1566), Online publication date: 1-Apr-2004.LENG W, DAVIES B, TARIN T, SWEENEY D and CHANCELLOR M (2018) DELAYED TREATMENT OF BLADDER OUTLET OBSTRUCTION AFTER SLING SURGERY: ASSOCIATION WITH IRREVERSIBLE BLADDER DYSFUNCTIONJournal of Urology, VOL. 172, NO. 4 Part 1, (1379-1381), Online publication date: 1-Oct-2004. Volume 169Issue 2February 2003Page: 535-539 Advertisement Copyright & Permissions© 2003 by American Urological Association, Inc.Keywordstreatment outcomeevaluation studiesurodynamicsfollow-up studiesprostatic hyperplasiaMetricsAuthor Information COSIMO de NUNZIO More articles by this author GIORGIO FRANCO More articles by this author ANDREA ROCCHEGIANI More articles by this author FRANCESCO IORI More articles by this author COSTANTINO LEONARDO More articles by this author CESARE LAURENTI More articles by this author Expand All Advertisement PDF downloadLoading ...