Evaluation of urodynamic parameters in patients with benign prostatic hyperplasia (BPH) and lower urinary tract symptoms

Objectives
Lower urinary tract symptoms (LUTS) are suggestive of BOO secondary BPH, a surgical treatment is the method
of choice. Urodynamic examination is the gold standard for diagnosis of BOO. The aim of the study is to evaluate
the effect of BOO on M.Detrusorbefore and after surgical treatment of BPH.
Materials and Methods
The subjects of this study were 20 patients with BPH and LUTS who had urodynamic tests before and after TURP
(transurethral prostatic resection) or open prostatectomy in 2019.
Results
58 patients underwent urodynamic tests prior to planned surgery for BPH, 20 patients confirmed participation
in the study. 12 patients underwent TURP (Group I), 8 patients - open prostatectomy (Group II). Transrectal
prostate ultrasonography was performed to determine the prostate size and volume. The average prostate
volume was 68.25 ml in the Group I, and 144.62 ml in the Group II. Post – void residual urine (> 100 ml) was
present in 11 patients. The mean IPSS before surgery in both groups was 22.8, which corresponds to severe
symptoms according to the International Prostate Symptom Score. After surgery - 3.3. The average flow rate
(Q max) before surgery was 7.1 ml / s in the Group I, after surgery 18.8 ml / s. In the Group II Q max was 4.8
ml / s, after surgery Q max was 17.8 ml / s. The mean bladder outlet obstruction index (BOOI) in the Group I
before surgery - 52.6, in Group II 82.3. In a repeat examination, no patient had a BOOI greater than 30. Preoperative M.Detrusorhyperactivity was in 12 patients. Repeated urodynamic tests in these patients didn’t reveal
M.Detrusorhyperactivity after surgery.
Conclusions
Patients with clinically and urodynamically proven M. Detrusor hyperactivity after surgical treatment of BPH reduces the symptoms of overactive bladder, which significantly improves quality of life