title: Patients with bladder outlet obstruction who refuse treatment show no clinical and urodynamic change after long-term follow-up.
abstract: OBJECTIVE
  To evaluate in patients with mild bladder outlet obstruction (BOO) who refused the proposed treatment and were on watchful waiting (WW), the symptomatic and urodynamic changes after 1-5 years of follow-up.
  
  
  METHODS
  102 patients with lower urinary tract symptoms (LUTS) and BOO (Schafer class: 2-6, median 3) were clinically and urodinamically re-evaluated after 1-5 years of follow-up. Of these, 82 were submitted to medical (alfuzosin or finasteride) or surgical treatment (prostatectomy or TUIP) and 20, who refused the proposed treatment, were on WW. A retrospective study was made on these 20 patients who underwent a second International Prostatic Symptom Score and pressure-flow evaluation after 1-5 years (median: 22 months) of watchful waiting. Wilcoxon matched-pairs signed-ranks test and Kruskal Wallis as appropriate were used for statistical analysis.
  
  
  RESULTS
  In the group of patients who refused the proposed treatment, no statistically significant differences between the two evaluations were observed for any of the parameters investigated: International Prostatic Symptom Score (15.1 +/- 6.8; 14.7 +/- 7.5); maximum flow (11.5 +/- 4.2; 12.1 +/- 4.3); residual urine (90.2 +/- 154.5; 113.3 +/- 158.4); Schäfer class (2.9 +/- 0.9; 2.8 +/- 1.2); Urethral Resistance Algorithm (37.1 +/- 14.4; 37.3 +/- 16.3); Projected Isometric Pressure (113.7 +/- 26.5; 112.7 +/- 21.8).
  
  
  CONCLUSIONS
  Patients with mild BOO may remain clinically and urodynamically stable for a long time.
authors.affiliation: "U. Bracci", Department of Urology "La Sapienza" University, Rome, Italy. giorgio.franco@libero.it
authors.forename: Giorgio
authors.initials: G
authors.lastname: Franco
authors.forename: Cosimo
authors.initials: C
authors.lastname: De Nunzio
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Minardi
authors.forename: Andrea
authors.initials: A
authors.lastname: Rocchegiani
authors.forename: Francesco
authors.initials: F
authors.lastname: Iori
authors.forename: Costantino
authors.initials: C
authors.lastname: Leonardo
authors.forename: Cesare
authors.initials: C
authors.lastname: Laurenti
mesh_terms: D000368:Aged; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011470:Prostatic Hyperplasia / Q000150:complications; D012189:Retrospective Studies; D013997:Time Factors; D016312:Treatment Refusal; D001748:Urinary Bladder Neck Obstruction / Q000209:etiology / Q000503:physiopathology*; D014563:Urodynamics