Bladder dysfunction in patients with benign prostatic hyperplasia: relevance of cystometry as prognostic indicator of the outcome after prostatectomy.
BACKGROUND
We correlated cystometric findings to the clinical features of benign prostatic hyperplasia (BPH) and compared them in terms of outcome after prostatectomy.


METHODS
Cystometric findings obtained from 78 patients who underwent prostatectomy were correlated with clinical features in BPH patients. In 41 consecutive patients of this group, prospective periodical cystometry was also performed.


RESULTS
Low bladder compliance correlated significantly with an increase in age and prostate volume, detrusor instability and impaired contractility. Low compliance also correlated with irritative symptoms, decreased maximum flow rate, increased post-void residual urine and an increase in the American Urological Association symptom score. Postoperative persistent incontinence was associated with low bladder compliance and detrusor instability. In a prospective study, bladder dysfunction was not completely restored in 53% of patients examined at a mean interval of 7.7 months after prostatectomy.


CONCLUSIONS
Among the cystometric parameters investigated, low compliance was the most relevant to the clinical features of BPH and had some predictive value for the outcome after prostatectomy. In about half of the BPH patients with bladder dysfunction preoperatively, this condition was irreversible for a significant period of time after prostatectomy, in spite of surgical relief of the infravesical obstruction.
Akino
H
H
Department of Urology, Fukui Medical School, Japan.
Gobara
M
M
Okada
K
K
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D008297:Male; D008875:Middle Aged; D009119:Muscle Contraction; D011183:Postoperative Complications; D011184:Postoperative Period; D011237:Predictive Value of Tests; D011300:Preoperative Care; D011468:Prostatectomy; D011470:Prostatic Hyperplasia / Q000150:complications / Q000601:surgery*; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000503:physiopathology; D001745:Urinary Bladder Diseases / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D014555:Urination Disorders / Q000209:etiology / Q000601:surgery; D014563:Urodynamics