Urodynamic assessment and quantification of prostatic obstruction before and after transurethral resection of the...

The clinical manifestations of benign prostatic hypertrophy (BPH) are ascribed entirely to the infravesical obstruction. Therefore relief of symptoms is pursued by surgical removal of obstruction, i.e. prostatectomy. On the other hand, it is generally accepted that the conventional clinical signs and symptoms do not correlate with obstruction as urodynamically defined. In the present study, objective obstruction and detrusor contractility parameters were calculated from detrusor pressure and flow rate measurements in 22 patients before and after transurethral resection of the prostate (TURP) using the computer program CLIM. The results indicate: (1) that CLIM supplies reliable obstruction and contractility parameters for preoperative assessment and follow-up in patients with BPH and (2) that greater than 25% of the patients, who underwent TURP, were objectively not obstructed. These findings form strong arguments for including CLIM parameters in the preoperative assessment to perform a TURP.