The follow-up of patients with unfavourable early results of transurethral prostatectomy.
OBJECTIVE
To determine the natural course of patients with subjectively disappointing early results after transurethral prostatectomy (TURP), who experience prolonged discomfort and an initial deterioration in symptoms.


METHODS
A consecutive series of 127 patients undergoing urodynamic studies and TURP were assessed 3 months after surgery using symptom scores and measurements of urinary flow rate; 107 patients reported improved symptom and quality-of-life scores, but 20 did not improve, with no change or a deterioration. These 20 patients were followed for several months using symptom scores, and measurements of flow rates and residual urine volumes. Baseline variables, including preoperative urodynamic studies, were compared between those who improved and those who did not.


RESULTS
Over a mean (range) follow-up of 10.6 (6-15) months, all those initially not improving showed spontaneous improvement in all three variables with no further treatment and eventually achieved the same significant degree of improvement as those who improved soon after TURP. Preoperatively, those initially not improving had mean lower symptom scores, more bladder irritability and less obstruction than did those who improved.


CONCLUSIONS
A significant proportion (approximately 15%) of patients with obstructive symptoms will experience considerable symptomatic discomfort for a prolonged period after an uncomplicated TURP and will not gain the full symptomatic benefit from the procedure until 6-9 months afterward.
Hakenberg
O W
OW
Division of Surgery (Urology), Repatriation General Hospital, Daw Park, South Australia.
Pinnock
C B
CB
Marshall
V R
VR
D000368:Aged; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011182:Postoperative Care / Q000379:methods; D011312:Pressure; D011446:Prospective Studies; D011468:Prostatectomy / Q000379:methods*; D011470:Prostatic Hyperplasia / Q000503:physiopathology / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome; D016055:Urinary Retention / Q000209:etiology / Q000601:surgery; D014554:Urination / Q000502:physiology; D014563:Urodynamics