Recovery of Voiding Efficiency and Bladder Function in Male Patients with Non-neurogenic Detrusor Underactivity after Transurethral Bladder Outlet Surgery

To investigated the treatment outcome in this group of men with detrusor underactivity (DU) and voiding dysfunction who underwent transurethral resection or incision of the prostate (TURP or TUIP). DU usually affects decision making whether bladder outlet surgery is necessary.

A total of 60 men with urodynamic DU and voiding dysfunction who underwent TURP or TUIP from 1998 to 2015 were retrospectively analyzed for their treatment outcome after follow-up for more than one year. DU was defined as urodynamic evidence of low detrusor pressure (<40 cmH2O), low flow rate (<10 ml/s), a post-void residual (PVR) urine volume >300 mL and a voiding efficiency (VE) of <33%. Satisfactory outcome was defined as improved quality of life and having a VE of >50% after treatment. Predictive factor for a successful outcome was also analyzed.

At a mean follow-up of 31 months, 49 (81.7%) patients had achieved a satisfactory treatment outcome. Among the patients who received TURP and TUIP, 38/44 (86.4%) and 11/16 (68.8%) had satisfactory outcome, respectively. The satisfactory group had significantly higher detrusor pressure (Pdet) and greater bladder compliance at baseline than the unsatisfactory group. There was significant improvement in the urodynamic parameters after treatment in the satisfactory group. Among the patients with satisfactory outcome, 34 (69.4%) patients had recovery of detrusor function within 3 months.

Active surgical treatment such as TURP or TUIP results in recovery of voiding efficiency and detrusor function within 3 months after treatment in the majority of patients with DU.

Urology. 2018 Oct 08 [Epub ahead of print]

Kau Han Lee, Hann-Chorng Kuo

Division of Urology, Department of Surgery, Chi-Mei Medical Center, Tainan, Taiwan. Electronic address: ., Department of Urology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan. Electronic address: .

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