QUANTIFICATION OF VOIDING DYSFUNCTION IN PATIENTS AWAITING TRANSURETHRAL PROSTATECTOMY

Purpose: We investigated the role of advanced urodynamic analysis in t he diagnostic evaluation for transurethral resection of the prostate. Materials and Methods: A total of 62 consecutive patients awaiting tra nsurethral resection of the prostate with an American Urological Assoc iation symptom score of more than 12, peak flow rate less than 13 ml. per second and significant residual urine underwent routine video pres sure-flow studies with advanced urodynamic analysis to quantify outflo w function. Postoperative outcome was assessed at 3 months by symptom scores, uroflowmetry and ultrasonography (residual urine). Results: Th e parameters used in the diagnostic evaluation for transurethral resec tion of the prostate did not correlate with urodynamic diagnosis of un equivocal obstruction. Weak detrusor contractility (without significan t obstruction) accounted for voiding dysfunction in 50% of the patient s. The results of transurethral resection of the prostate were signifi cantly better in patients with unequivocal compared to equivocal obstr uction. Furthermore, patients with unequivocal obstruction but weak de trusor contractility had a significantly poorer treatment outcome. Con clusions: Advanced urodynamic analysis in the diagnostic evaluation of patients with symptomatic benign prostatic hyperplasia can predict tr eatment outcome and, therefore, allows the urologist to choose the mos t appropriate therapeutic option for individuals.