Role of Bladder Functional Testing Prior to Surgeries for Benign Prostatic Obstruction

Area of Science:

• Urology
• Surgical Assessment
• Lower Urinary Tract Symptoms

Background:

• Benign prostatic obstruction (BPO) causing lower urinary tract symptoms (LUTS) often requires surgical intervention.
• Surgical outcomes for BPO can be variable, highlighting the need for accurate preoperative assessment.
• Current guidelines lack consensus on the routine use of preoperative functional testing.

Purpose of the Study:

• To review recent findings and controversies surrounding preoperative functional testing for BPO.
• To evaluate the benefits and limitations of urodynamic studies (UDS) and alternative methods.
• To emphasize improved preoperative characterization for better surgical decision-making.

Main Methods:

• Narrative review of existing literature on preoperative functional testing for BPO.
• Analysis of the role of urodynamic studies (UDS) in assessing bladder outlet obstruction (BOO).
• Exploration of less-invasive diagnostic approaches, such as Urocuff.

Main Results:

• Urodynamic study (UDS) is the gold standard for assessing bladder outlet obstruction (BOO) and predicting surgical success, yet its routine use is not recommended.
• There is a surprising lack of strong evidence supporting or refuting the routine use of UDS.
• Non-invasive Urocuff testing shows promise for assessing BOO with a less-invasive approach.
• Accurate preoperative assessment of BOO and bladder function can aid in patient counseling and expectation setting.

Conclusions:

• Improved preoperative characterization of patients with BPO is crucial for optimizing surgical decision-making.
• Confirming BOO and bladder function preoperatively can enhance patient counseling and post-operative expectations.
• Further research into less-invasive and standardized preoperative assessments is warranted to improve surgical outcomes for LUTS.