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Does a Pre-Operative Urodynamic Diagnosis of Bladder Outflow Obstruction Improve Outcomes from Palliative Transurethral Prostatectomy?

Lookup NU author(s): Vincent Gnanapragasam

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Abstract

Objective: Palliative transurethral prostatectomy (TURP) is the mainstay of treatment for lower urinary tract symptoms, (LUTS) in men with prostate cancer. Functional outcomes, however, can often be unsatisfactory. Here the value of pre-operative urodynamics was investigated in these men. Methods: A retrospective review was conducted of 41 men with prostate cancer and LUTS who were investigated by urodynamics prior to TURP. All were treated solely by primary androgen deprivation. 19 men with urodynamic proven bladder outlow obstruction (BOO) proceeded to palliative TU RP. Results: Of the 41 men investigated by cystometry, the urodynamic diagnosis was BOO in 12 (29%) men, detrusor overactivity in 12 (29%) men with 7 (17%) having both diagnoses. 6 (15%) men were found to have underactive or acontractile detrusors while 4 (10%) had normal studies. In men who proceeded to TURP, all demonstrated improved flow rates (p = 0.003). At 12 months, 95% were voiding spontaneously with only 1 man requiring permanent re-catheterisation. These results compared very favourably to published outcomes which have not used urodynamics to select men for surgery. Conclusions: Urodynamics may help identify objective BOO prior to palliative TURP. Further prospective trials are justified to assess the role of urodynamics in this context. Copyright (C) 2010 S. Karger AG, Basel


Publication metadata

Author(s): Gnanapragasam VJ, Leonard A

Publication type: Article

Publication status: Published

Journal: Urologia Internationalis

Year: 2011

Volume: 86

Issue: 1

Pages: 85-89

Print publication date: 01/02/2011

ISSN (print): 0042-1138

ISSN (electronic): 1423-0399

Publisher: S. Karger AG

URL: http://dx.doi.org/10.1159/000318568

DOI: 10.1159/000318568


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