TURP in urodynamicaly proven hypocontractile detrusor. Are we doing justice to our patients??
BAUS ePoster online library. Shah P. 06/25/19; 259590; P9-4
Dr. Pratikkumar Shah
Dr. Pratikkumar Shah
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Abstract
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Introduction:
In a small subset of patients bladder outlet obstruction and detrusor hypo contractility overlap each other for LUTS.

Aim:
To evaluate the efficiency of TURP in hypo contractility detrusor patients.

Patients and Methods:

After institutional scientific and ethical committee approval prospective data of patients (> 50 yrs) having symptoms of LUTS (IPSS > 8) (Qmax < 10 ml/sec) along with prostatomegaly (prostate volume > 50cc) and with detrusor under activity (DUA) was collected during period from january 2015 to january 2017. Hypocontractile detrusor on urodynamic study was defined as Pdet Qmax< 30 cm H2O and BOO was judged based on prostatomegaly on USG (prostate >50cc) with Qmax<10 ml/sec. Patients having carcinoma prostate on TURP histopathology reports & Diabetics were excluded from study. Outcomes were determined by comparing pre-operative & post-operative values of IPSS score, QOL score, Qmax, PVR and Pdet@Qmax after 3 months of TURP.

Results:

Out of initial 52 enrolled patients 36 were available for follow up. The mean duration of follow up was 16 months. Mean IPSS values improved from 21.1 to 16.3, QOL improvement from a preoperative mean value of 3.7 to postoperative value of 2.3 (p value < 0.001) .The Qmax improved from mean value of 7.5 preoperatively to 13.9 postoperatively. The PVR values reduced from 229 ml to 84 ml and bladder voiding efficiency improved from 46% preoperatively to 77% post operatively.

CONCLUSION:
Patients who undergo TURP for BOO, despite having DUA, have significant improvement in their IPSS score and quality of life.
Introduction:
In a small subset of patients bladder outlet obstruction and detrusor hypo contractility overlap each other for LUTS.

Aim:
To evaluate the efficiency of TURP in hypo contractility detrusor patients.

Patients and Methods:

After institutional scientific and ethical committee approval prospective data of patients (> 50 yrs) having symptoms of LUTS (IPSS > 8) (Qmax < 10 ml/sec) along with prostatomegaly (prostate volume > 50cc) and with detrusor under activity (DUA) was collected during period from january 2015 to january 2017. Hypocontractile detrusor on urodynamic study was defined as Pdet Qmax< 30 cm H2O and BOO was judged based on prostatomegaly on USG (prostate >50cc) with Qmax<10 ml/sec. Patients having carcinoma prostate on TURP histopathology reports & Diabetics were excluded from study. Outcomes were determined by comparing pre-operative & post-operative values of IPSS score, QOL score, Qmax, PVR and Pdet@Qmax after 3 months of TURP.

Results:

Out of initial 52 enrolled patients 36 were available for follow up. The mean duration of follow up was 16 months. Mean IPSS values improved from 21.1 to 16.3, QOL improvement from a preoperative mean value of 3.7 to postoperative value of 2.3 (p value < 0.001) .The Qmax improved from mean value of 7.5 preoperatively to 13.9 postoperatively. The PVR values reduced from 229 ml to 84 ml and bladder voiding efficiency improved from 46% preoperatively to 77% post operatively.

CONCLUSION:
Patients who undergo TURP for BOO, despite having DUA, have significant improvement in their IPSS score and quality of life.

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