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The effect of prostatectomy on upper urinary tract function.

H H Meyhoff, O Munck, C Juul

    Scandinavian Journal of Urology and Nephrology
    |January 1, 1982
    PubMed
    Summary
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    Prostatectomy improves upper urinary tract function in patients with benign prostatic hypertrophy (BPH) and obstruction. This study evaluated 59 BPH patients, finding that prostate surgery relieved urinary tract obstruction, regardless of the surgical method used.

    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.

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    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.