The 12-year symptomatic outcome of transurethral resection of the prostate for patients with lower urinary tract symptoms suggestive of benign prostatic obstruction compared to the urodynamic findings before surgery.
OBJECTIVE
To investigate whether bladder outlet obstruction (BOO), detrusor underactivity (DUA) and detrusor overactivity (DO) affect the long-term outcome of transurethral resection of the prostate (TURP) for patients having lower urinary tract symptoms suggestive of benign prostatic obstruction.


METHODS
Of 92 patients who had TURP after a urodynamic study between 1995 and 1997, 43 (47%) were alive at the time of the survey in February 2008. Nine patients were excluded because of prostate cancer, neurological diseases and the impossibility of symptomatic examination. The International Prostate Symptom Score (IPSS) and quality-of-life (QoL) index were determined at baseline, 3 months, 3, 7 and 12 years after surgery for 34 patients.


RESULTS
Although the improved IPSS and QoL index at 3 months gradually deteriorated with time, patients at 12 years were still significantly better than those at baseline. The IPSS in patients without BOO deteriorated faster than in those with it, whereas neither DUA nor DO influenced the slope of change in IPSS. Regardless of the preoperative urodynamic findings, the QoL index remained improved for 12 years. Two-thirds of patients with DUA but not BOO were satisfied with their urinary condition at 12 years.


CONCLUSIONS
The symptomatic improvement provided by TURP lasts for >10 years, although there is a gradual deterioration with time. The QoL index remained improved for 12 years regardless of the preoperative urodynamic findings.
Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Japan. masumori@sapmed.ac.jp
Naoya
N
Masumori
Ryoji
R
Furuya
Yoshinori
Y
Tanaka
Seiji
S
Furuya
Hiroshi
H
Ogura
Taiji
T
Tsukamoto
D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D017060:Patient Satisfaction; D011470:Prostatic Hyperplasia / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D053448:Prostatism / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D020728:Transurethral Resection of Prostate; D016896:Treatment Outcome; D001748:Urinary Bladder Neck Obstruction / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D014563:Urodynamics