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Bladder outflow tract obstruction and urinary retention from benign prostatic hypertrophy treated by balloon
K P Gill1, L S Machan, D J Allison
1Department of Surgery, Royal Postgraduate Medical School, Hammersmith Hospital, London.
Abstract:
Forty-eight men with urodynamically proven bladder outflow tract obstruction (BOO) and 19 with retention secondary to benign prostatic hypertrophy were treated by balloon dilatation of the prostate as out-patients; 31 were dilated with 20 mm and 36 with 25 mm balloons. Of the 48 men with BOO, 37 had repeat cystometrograms at intervals ranging from 3 to 11 months after dilatation and 33 (89%) remained obstructed by urodynamic criteria. Of 6 who only had a peak flow rate assessment, 5 had a flow less than 12 ml/s. Of the 19 patients in retention only 3 were able to void and all are obstructed. Symptoms of hesitancy, poor stream, frequency and nocturia were improved in less than 50% of patients. No reliable correlation was found between objective response and balloon size, length of time of dilatation, prostate size or morphology, detrusor pressure or stability, or post-dilatation urethrogram appearances. Balloon dilatation to 25 mm is not adequate therapy for bladder outflow tract obstruction or urinary retention from prostatic hypertrophy.