Correlations of urodynamic changes with changes in symptoms and well-being after transurethral resection of the prostate
Correlations of urodynamic changes with changes in symptoms and well-being after transurethral resection of the prostate
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DOI：
10.1016/s0022-5347(05)64688-5
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发表时间：
2002-08-01
影响因子：
6.6
通讯作者：
Boon, TA
中科院分区：
文献类型：
--
作者：
van Venrooij, GEPM;van Melick, HHE;Boon, TA
目的：为了建立尿动力学对经尿道前列腺切除术后良性前列腺肿大预后的预测价值，我们将尿动力学变化与经尿道前列腺切除术后症状改善、烦恼减少、总体幸福感和生活质量的提高联系起来。材料和方法：选择符合研究标准并接受国际良性前列腺增生科学委员会推荐的检查的下尿路症状的男性，并估计空后残余尿量和前列腺大小。患者分别回答生活质量、症状指数、症状问题指数和良性前列腺增生影响指数问题。患者还接受了尿动力学评估。当选择经尿道前列腺切除术作为治疗方式时，将男性纳入分析。在纳入的132例患者中，有93例在经尿道前列腺切除术后6个月进行了重新评估。结果：经尿道前列腺切除术后改善与膀胱出口梗阻减少显著相关（p < 0.01）。然而，32例术前通畅或不通畅的患者也从切除中获益。有效容量，即膀胱容量减去空后残余尿量，术后平均增加45%。有效容量的增加有助于显著减少症状和烦恼，并改善健康状况。在经尿动力学证实膀胱稳定的患者中，90%的患者在前列腺切除术后膀胱保持稳定，而经尿动力学证实膀胱不稳定的患者中，50%的患者术后膀胱恢复稳定。结论：术前行尿动力学有助于预测经尿道前列腺切除术后症状缓解程度、烦恼减少程度和幸福感增加程度。
Purpose: To establish the predictive value of urodynamics on the outcome of transurethral prostate resection for benign prostatic enlargement we correlated urodynamic changes with symptomatic improvement, decreased bother, and increased general well-being and quality of life after transurethral prostate resection.Materials and Methods: Men with lower urinary tract symptoms were selected if they met study criteria and underwent tests recommended by the International Scientific Committee on Benign Prostatic Hyperplasia, and if post-void residual urine volume and prostate size were estimated. Patients answered quality of life, symptom index, symptom problem index and benign prostatic hyperplasia impact index questions. Patients also underwent urodynamic evaluation. Men were included in analysis when transurethral prostate resection was selected as the treatment modality. Of the 132 patients included 93 were reevaluated 6 months after transurethral prostate resection.Results: Improvements after transurethral prostate resection were significantly associated with decreased bladder outlet obstruction (p < 0.01). However, 32 cases that were unobstructed or equivocal preoperatively also benefited moderately from resection. Effective capacity, that is cystometric capacity minus post-void residual urine volume, increased by an average of 45% postoperatively. The increase in effective capacity contributed to a significant decrease in symptoms and bother, and to improved well-being. Of the men with a urodynamically proved stable bladder 90% maintained a stable bladder after prostatectomy, while in 50% with a urodynamically proved unstable bladder it became stable postoperatively.Conclusions: Performing urodynamics preoperatively helps to predict the degree of symptom relief, decreased bother and increased well-being after transurethral prostate resection.