Platinum open access journal
pISSN 2466-0493 eISSN 2466-054X
Indexed in MEDLINE, SCIE, Scopus, DOAJ and more
    Korean J Urol. 2008 Oct;49(10):912-916. Korean.
    Published online Oct 31, 2008.
    https://doi.org/10.4111/kju.2008.49.10.912
    Copyright © 2008 The Korean Urological Association
    Original Article

    The Influences of Bladder Outlet Obstruction on Improvement of Storage Symptoms in Patients Who Underwent Transurethral Resection of Prostate

    Ho Young Chung, Dong Seok Han, Young Seop Jang and Ki Hak Song
      • Department of Urology, Konyang University College of Medicine, Daejeon, Korea.
    Received June 18, 2008; Accepted August 25, 2008.

    Abstract

    Purpose

    To investigate the influences of preoperative bladder outlet obstruction (BOO) to be adjusted by age and prostate volume on improvement of storage symptoms in patients who underwent transurethral resection of prostate (TURP) in a long term follow up.

    Materials and Methods

    We performed retrospective study of 75 patients with benign prostatic hyperplasia (BPH) who had undergone TURP and preoperative urodynamics from July 2004 to December 2006. 18 patients of them were lost follow up in this period, so we analyzed 57 patients in this study. The degrees of BOO were measured by the Abrams-Griffiths (AG) number calculated according to the preoperative urodynamic data. International Prostate Symptom Score (IPSS) questionnaire were used to evaluate improvement of symptoms. Especially IPSS questions number 2, 4 and 7 were used to evaluate storage symptoms. Partial correlation analysis was done between the AG numbers and the degree of storage symptoms improvement, adjusted by the age and the prostate volume.

    Results

    There were significant decreases of the IPSS (p=0.029), storage symptom score (p=0.024) and frequency score (p=0.017) in BOO group compared to the non-BOO group. The changes of IPSS (γ=-0.338, p=0.012), storage symptoms score (γ=-0.292, p=0.031) and frequency symptom score (γ=-0.305, p=0.023) were significantly correlated with AG number.

    Conclusions

    These results suggested that the preoperative AG number derived from urodynamics was an important factor in predicting the postoperative results. It would be expected that the patients with high AG numbers might be more improved storage symptom after TURP.

    Keywords
    Prostatic hyperplasia; Urodynamics; Urinary bladder neck obstruction; Transurethral resection of prostate

    Figures

    Fig. 1
    Comparison of the changes of symptom scores before and after TURP between the patients with and without bladder outlet obstruction. The patients with bladder outlet obstruction showed significant decrease of IPSS, storge symptom score and frequency score after TURP comparing with the patients without bladder outlet obstruction (p<0.05). Each bar is mean±SE. AG number: Abrams-Griffith number, TURP: transurethral resection of the prostate, BOO: bladder outlet obstruction.

    Tables

    Table 1
    Comparison of the preoperative clinical findings

    Table 2
    Comparison of the changes of the symptom scores before and after TURP between the patients with and without bladder outlet obstruction

    Table 3
    Partial correlation between AG numbers and changes of symptom scores before and after TURP adjusted by age & prostate volume

    References

      1. Seki N, Takei M, Yamaguchi A, Naito S. Analysis of prognostic factors regarding the outcome after a transurethral resection for symptomatic benign prostatic enlargement. Neurourol Urodyn 2006;25:428–432.
      1. Chapple CR, Roehrborn CG. A shifted paradigm for the further understanding, evaluation, and treatment of lower urinary tract symptoms in men: focus on the bladder. Eur Urol 2006;49:651–658.
      1. Cabelin MA, Te AE, Kaplan SA. Benign prostatic hyperplasia: challenges for the new millennium. Curr Opin Urol 2000;10:301–306.
      1. Seki N, Yunoki T, Tomoda T, Takei M, Yamaguchi A, Naito S. Association among the symptoms, quality of life and urodynamic parameters in patients with improved lower urinary tract symptoms following a transurethral resection of the prostate. Neurourol Urodyn 2008;27:222–225.
      1. Djavan B. Lower urinary tract symptoms/benign prostatic hyperplasia: fast control of the patient's quality of life. Urology 2003;62(3 Suppl 1):6–14.
      1. Roehrborn CG. Current medical therapies for men with lower urinary tract symptoms and benign prostatic hyperplasia: achievements and limitations. Rev Urol 2008;10:14–25.
      1. Mirone V, Imbimbo C, Longo N, Fusco F. The detrusor muscle: an innocent victim of bladder outlet obstruction. Eur Urol 2007;51:57–66.
      1. AUA Practice Guidelines Committee. AUA guideline on management of benign prostatic hyperplasia (2003). Chapter 1: diagnosis and treatment recommendations. J Urol 2003;170:530–547.
      1. Tanaka Y, Masumori N, Itoh N, Furuya S, Ogura H, Tsukamoto T. Is the short-term outcome of transurethral resection of the prostate affected by preoperative degree of bladder outlet obstruction, status of detrusor contractility or detrusor overactivity? Int J Urol 2006;13:1398–1404.
      1. Eckhardt MD, van Venrooij GE, Boon TA. Urethral resistance factor (URA) versus Schäfer's obstruction grade and Abrams-Griffiths (AG) number in the diagnosis of obstructive benign prostatic hyperplasia. Neurourol Urodyn 2001;20:175–185.
      1. Hakenberg OW, Linne C, Manseck A, Wirth MP. Bladder wall thickness in normal adults and men with mild lower urinary tract symptoms and benign prostatic enlargement. Neurourol Urodyn 2000;19:585–593.
      1. Oelke M, Hofner K, Jonas U, Ubbink D, de la Rosette J, Wijkstra H. Ultrasound measurement of detrusor wall thickness in healthy adults. Neurourol Urodyn 2006;25:308–317.
      1. Kojima M, Inui E, Ochiai A, Nava Y, Ukimura O, Watanabe H. Noninvasive quantitative estimation of infravesical obstruction using ultrasonic measurement of bladder weight. J Urol 1997;157:476–479.
      1. Tubaro A, Carter S, Hind A, Vicentini C, Miano L. A prospective study of the safety and efficacy of suprapubic transvesical prostatectomy in patients with benign prostatic hyperplasia. J Urol 2001;166:172–176.
      1. Kojima M, Inui E, Ochiai A, Naya Y, Kamoi K, Ukimura O, et al. Reversible change of bladder hypertrophy due to benign prostatic hyperplasia after surgical relief of obstruction. J Urol 1997;158:89–93.
      1. Steers WD, Kolbeck S, Creedon D, Tuttle JB. Nerve growth factor in the urinary bladder of the adult regulates neuronal form and function. J Clin Invest 1991;88:1709–1715.
      1. Steers WD, Ciambotti J, Etzel B, Erdman S, de Groat WC. Alterations in afferent pathways from the urinary bladder of the rat in response to partial urethral obstruction. J Comp Neurol 1991;310:401–410.
      1. Dinis P, Silva J, Ribeiro MJ, Avelino A, Reis M, Cruz F. Bladder C-fiber desensitization induces a long-lasting improvement of BPH-associated storage LUTS: a pilot study. Eur Urol 2004;46:88–94.
      1. Abrams P. Objective evaluation of bladder outlet obstruction. Br J Urol 1995;76 Suppl 1:11–15.
      1. Andersson KE. LUTS treatment: future treatment options. Neurourol Urodyn 2007;26 6 Suppl:934–947.
      1. Choi HJ, Lee KS. Detrusor overactivity in patients with benign prostatic obstruction: the clinical and urodynamic characteristic. Korean J Urol 2005;46:805–809.
      1. Rosier PF, de la Rosette JJ. Is there a correlation between prostate size and bladder-outlet obstruction? World J Urol 1995;13:9–13.
      1. Lee KS, Hong SJ, Lee MS. The correlation between ultrasonic parameters of the prostate and the bladder outlet obstruction in BPH patients. Korean J Urol 2000;41:65–70.
      1. Roehrborn CG, McConnell JD, Lieber M, Kaplan S, Geller J, Malek GH, et al. The PLESS Study Group. Serum prostate-specific antigen concentration is a powerful predictor of acute urinary retention and need for surgery in men with clinical benign prostatic hyperplasia. Urology 1999;53:473–480.
      1. Marberger MJ, Andersen JT, Nickel JC, Malice MP, Gabriel M, Pappas F, et al. Prostate volume and serum prostate-specific antigen as predictors of acute urinary retention. Combined experience from three large multinational placebo-controlled trials. Eur Urol 2000;38:563–568.
      1. Laniado ME, Ockrim JL, Marronaro A, Tubaro A, Carter SS. Serum prostate-specific antigen to predict the presence of bladder outlet obstruction in men with urinary symptoms. BJU Int 2004;94:1283–1286.
      1. Jung YS, Hwang TK, Kim JC. The outcome and satisfaction of patients with lower urinary tract symptoms/benign prostatic hyperplasia following transurethral resection of the prostate according to urodynamic obstruction and the bladder function. Korean J Urol 2007;48:965–970.
    Cited by
    Crossref 4
    Google Scholar 
    Scopus 4
    Metrics
    Share
    Figures
    slide

    1 / 1

    Tables
    slide
    slide
    slide

    1 / 3

    PERMALINK