Evaluation of outcome of prostatectomy in patients with BPH and weak detrusor contractility / Ahmed Mohammed Abdelmageed Mohammed Rammah ; Supervised Mohammed Salah Abdelazeem , Mohammed Galal Elsheikh , Mahmmoud Amr Abdelhakim

Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Urology

Background: Patients with benign prostatic hyperplasia (BPH) suffering from detrusor underactivity were generally regarded unsuitable for surgery. This prospective study is to evaluate the efficacy of prostatectomy on BPH patients diagnosed with detrusor underactivity on pressure flow study (PFS). Methods Thirty two patients were included in the study with mean age of 64.66±9.42 years. Outcomes were determined by patients{u2019} self-assessment questionnaires, international prostate symptom score (IPSS) and international consultation questioner for urinary incontinence, and UDs parameters including maximum uroflow rate (Qmax), post void residual urine (PVR), bladder compliance, maximal cystometric capacity (CC), maximum detrusor pressure (Pdet @ max) and BCI. Results: The follow-up duration was 6 months. After prostatectomy, IPSS/ICQ-UI, Qmax, and P detmax were significantly improved and there were no significant differences with regard to bladder compliance, MCC, PVR and creatinine. The risk of failure for prostatectomy in patients with BPH and DU is about 44% (postvoid residual urine >300cc). Conclusion PFS may play a very important role in detecting bladder contractility index (BCI) in BPH patients with detrusor underactivity. TURP may obtain a promising effect on such patients with low BCI. These patients should not be arbitrarily excluded from surgical indications simply based on PFS findings

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