Meer, A.F. ter (2021) Long-term results of transurethral resection of the prostate in men with detrusor underactivity. thesis, Medicine.
Full text available on request.Abstract
Introduction and aim Detrusor underactivity (DU) is an important contributor of lower urinary tract symptoms (LUTS) in men. Traditionally, urologists are reserved in offering a transurethral resection of the prostate (TURP) to men with DU, fearing poorer clinical outcomes. In this study, long-term outcomes of TURP in men with DU were explored. Materials and methods For this retrospective chart review and prospective questionnaire study, neurologically intact male patients who underwent a TURP between 2010-2016 with a preoperative pressure-flow study (PFS) were analysed. Voiding patients on preoperative PFS were stratified by bladder contractility index (BCI) and DU patients (BCI<100) subsequently by bladder outlet obstruction index (BOOI), non-voiding patients were divided in an acontractile and contractile bladder group. Primary outcomes were spontaneous voiding and patient-reported treatment success. Results 155 patients were retrospectively analysed (median follow-up 78 (range 51-127) months): postoperative spontaneous voiding was present in 88.7% (55 of 62) of DU patients (BCI<100) vs 95.2% (59 of 62) of non-DU patients (BCI≥100) (P=0.187); in 90.9% (40 of 44) of obstructed (BOOI>40) vs 83.3% (15 of 18) of unobstructed (BOOI≤40) (P=0.392) DU patients; and in 40% (2 of 5) of acontractile vs 88.5% (23 of 26) of contractile bladder patients. 89 patients were prospectively analysed (median follow-up 79 (range 52-127) months): patient-reported treatment success was present in 71.1% (27 of 38) of DU patients vs 61.8% (21 of 34) of non-DU patients (P=0.404); 76% (19 of 25) of obstructed vs 61.5% (8 of 13) of unobstructed DU patients; and 50% (1 of 2) of acontractile vs 83.3% (10 of 12) of contractile bladder patients. Improvement of spontaneous voiding was found significant in obstructed DU patients (both retrospectively and prospectively; P<0.001). Conclusion TURP must be considered a valuable treatment option for selected DU patients since long-term outcomes are comparable to non-DU patients.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Witte, dr. L.P.W. |
| Faculty: | Medical Sciences |
| Date Deposited: | 07 Jan 2022 08:27 |
| Last Modified: | 07 Jan 2022 08:27 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2977 |
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