Kme. Jensen et al., LONG-TERM PREDICTIVE ROLE OF URODYNAMICS - AN 8-YEAR FOLLOW-UP OF PROSTATIC SURGERY FOR LOWER URINARY-TRACT SYMPTOMS, British Journal of Urology, 78(2), 1996, pp. 213-218
Objective To investigate the long-term predictive value of urodynamics
for the outcome of patients undergoing prostatic surgery for lower ur
inary tract symptoms (LUTS) suggestive of bladder outlet obstruction (
BOG) and to determine the long-term effectiveness on symptoms, maximum
now rate and the rate of re-operation. Patients and methods Of 139 el
derly men who had undergone prostatic surgery, selected without refere
nce to urodynamic assessment but having extensive (blinded) urodynamic
testing included in their evaluation, 79 were followed for 8 years us
ing a history, symptom score analysis, uroflowmetry and review of thei
r records. Results Comparing the results in groups of men with a pre-o
perative maximum now rate < or greater than or equal to 15 mL/s, there
was a similar difference in the rate of success to that noted 6 month
s post-operatively. Similar results were obtained when comparing those
with BOO or a normal bladder outlet function. However, although the t
endency was clear it was not statistically significant because of the
small sample size (type-2 error). There was a significant reduction in
all symptom scores from those assessed pre-operatively and during the
8 years (P<0.001). The median pre-operative maximum flow rate was 8.5
mL/s, compared with 12.5 mL/s after 8 years (P<0.001). Of the 79 pati
ents, 14 (18%) had 28 re-operations during the 8-year follow-up, 12 be
ing repeat resections of the prostate, giving a repeat resection rate
of 1.8% per year and a success rate of 71%. During the 8 years, 82% of
the patients had an unchanged overall evaluation of the post-operativ
e outcome. In general, those having an unsatisfactory outcome were sli
ghtly younger than the whole group. Conclusion Uroflowmetry and pressu
re-now studies can predict to some degree the long-term result after p
rostatic surgery. There was a durable effect on symptom scores and max
imum now rates after the operation. The annual rate of repeat resectio
n (1.8%) was relatively low.