| Benign prostate hyperplasia(BPH) is a common disease in the old people.Bladder outlet obstruction due to BPH is the major reason of low urinary tract syndrome(LUTS) in the old people.Releasing bladder outlet obstruction in time is the key to the treatment of BPH.At the same time,functional changes of detrusor muscle which is due to BPH have compact relationship with LUTS.When we make the treatment plan of BPH,function of detrusor muscle should also be considered.Transurethral electroresection(TURP) of prostate is the golden standard of BPH.We can find the functional change of detrusor muscle before and after TURP by urodynamics.So we can find the correlation of compliance,stability and systolic function of detrusor muscle. In our study,patients with BPH undergone urodynamics before and after operation. Objective index was used to indicate bladder function before and after operation in order to find the relationship between BPH and functional change of detrusor muscle. According to the key diagnosis highlight which was made by the forth consultation committee of BPH,we choosed 47 cases of BPH in our department.The time was from January,2004 to July,2004.All the cases had no nerve and endocrine disease.There was no prostate cancer,urethral stricture,injury of urethra and operation history of prostate, pelvic cavity and urethra.The age was from 58 to 83 and the average age was 68.5.All the cases were undergone TURP+TUVP.Before and after the operation, intimate urodynamics was done which included compliance,stability and systolic function of detrusor muscle.The following time was from 6 to 11 months and the average was 6.95 months.IPSS and QOL was recorded by patients themselves under the help of urology doctors. We found that IPSS decreased from (25.33±4.57) before operation to (10.62±3.89) after operation.QOL decreased from (5.32±0.81) before operation to (1.64±1.31) after operation.All the indicatrix of urodynamics obviously changed such as the max uroflometry,volume of the first desire and the max volume of bladder.The pressure of detrusor muscle decreased when the max uroflometry reached.Compliance of bladder recovered and there was few cases of unstable blader after operation.Contraction force of blader enhanced.In the 47 cases,there were 6 cases of Ⅲdegree,25 cases of Ⅳdegree,10 cases of Ⅴdegree and 6 cases of Ⅵdegree by PURR degrade before operation.12 cases had less systolic function of detrusor muscle which was under W+.There was unstable bladder in 29 cases,low compliance in 15 cases and high compliance in 4 cases.There was poor detrusor muscle in all the patients with high compliance.After the operation,there was unstable bladder in 4 cases,low compliance in 3 cases and high compliance in 2 cases. In our study,when the obstruction degree increased,unstable bladder also increased in the region of Ⅲto Ⅴ.It indicated that unstable bladder had positive relationship with obstruction degree.Most of unstable bladder disappeared after resection of prostate and no bladder outlet obstruction.When the obstruction degree increased,compliance decreased in the region of Ⅲto Ⅴand increased in the region of Ⅵ.It indicated that compliance had impact relationship with obstruction.In the early stage,obstruction degree had negative relationship with compliance.If there was further injury of detrusor muscle,compliance became high in the late period.Our study showed that there was significant change of compliance,stability and systolic... |
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