The Application Of Urodynamics To Transurethral Resection Of The Prostate (TURP)

Objective: Through the retrospective analysis of the relationshipbetween the preoperative urodynamic parameters and the curative effect oftransurethral resection of the prostate (TURP) in patients with hyperplasia ofprostate, to reevaluate the application value of urodynamic examinationbefore operation of TURP.Methods: We collected82patients with clinical data and follow-up datafrom2012January to2013May in Department of Urology of First AffiliatedHospital of Soochow University. These patients with benign prostatichyperplasia (BPH) were underwent transurethral resection of the prostate (TURP)operation. All pathological outcomes of these patients were prostatic hyperplasia,and underwent preoperative urodynamic tests. Analyze the preoperative data andthe postoperative data of3months, including: the international prostate symptomscore (IPSS), Quality of life score (QOL), OAB-V8score, maximum urinaryflow rate (Q-max), residual urine volume, urine flow parameters of dynamicinspection, to find out the correlation between the effect of TURP operation andthe preoperative urodynamic findings.Results: The success rate of initial trial without catheter trial (TWOC)was90.24%(74/82cases) in these82patients who were underwent TURPoperation. Their IPPS score were improved significantly (19.1±5.5beforeoperation Vs7.1±5.4after operation, P<0.01); their QOL score improvedsignificantly (4.3±1.7before operation Vs2.1±1.5after operation, P<0.05).Q-max was increased from9.6±5.2ml/s before operation to17.4±4.1ml/safter procedure; residual urine volume were significantly decreased from62.2 ±27.8ml before operation to23.2±11.6ml after operation. The postoperativeprimary TWOC success rate was98.39%(61/62cases), when the patients’detrusor pressure≥40cmH2O.The success rate Was significantly higher thanthe patients whose detrusor pressure <40cmH2O,and there success rate was65.00%(13/20cases), P<0.05. Moreover, the former postoperative subjectivesymptoms more significantly improved than the latter. Postoperative IPSSscore of the former was6.8±4.9, which was significantly better than thelatter whose score was10.5±4.5, P<0.05. Dynamic inspection results Showedthat the incidence rate of BPH complicated with OAB was20.73%(17/82cases) in this study, and the symptom of OAB was not significantlyalleviated after the operation. The OAB-V8score of the patients with BPHcomplicated with OAB was18.2±6.2before operation and15.3±5.8afteroperation, was not improved (P>0.05). In terms of urine dynamics testcomplications: There were2cases occurred with bacteremia after theurodynamic examination;6patients were suffered with severe urinaryirritation symptoms;5cases were occurred with hematuria.Conclusion:1.The curative effect of TURP operation was satisfactory intreating BPH, especially when the detrusor contractility is normal at Q-max,not only can significantly improve the IPSS score, but can improve thesuccess rate of first TWOC.2. In patients of BPH combined with OAB, weneed to control the symptoms of OAB before the TURP operation, then wecan obtain the favorable operation effect.3. Urodynamic examination maycause serious complications, we should choose carefully, and should treat thecomplications actively.