The effect of prostatectomy on upper urinary tract function

Area of Science:

• Urology
• Nephrology
• Nuclear Medicine

Background:

• Benign prostatic hypertrophy (BPH) can cause upper urinary tract obstruction.
• The impact of prostatectomy on renal function in BPH patients requires further clarification.

Purpose of the Study:

• To evaluate the influence of prostatectomy on upper urinary tract function in patients with obstructive BPH.
• To compare the effects of transvesical versus transurethral prostatectomy on renal function.

Main Methods:

• 59 patients with obstructive BPH underwent prostatectomy (transvesical or transurethral).
• [51Cr]EDTA clearance and gamma camera renography were used to assess upper urinary tract function preoperatively and at 6-month follow-up.
• Glomerular filtration rate (GFR), residual renal activity (A20), and half-peak time were measured.

Main Results:

• Preoperatively, 54% of patients showed upper urinary tract obstruction on renography, compared to 15% on IV pyelography.
• Prostatectomy relieved obstruction in patients with preoperative renographic findings, even with normal urography.
• Patients with obstruction had lower GFR values preoperatively.
• A slight, clinically insignificant decrease in GFR and increase in A20/half-peak time were observed in patients without preoperative obstruction.
• No significant differences in upper urinary tract function were noted between transurethral and transvesical prostatectomy.

Conclusions:

• Prostatectomy is effective in relieving upper urinary tract obstruction in BPH patients.
• Renography is more sensitive than IV pyelography in detecting upper urinary tract obstruction in BPH.
• Both transurethral and transvesical prostatectomy yield similar outcomes regarding upper urinary tract function.