The effect of prostatectomy on upper urinary tract function

59 patients with obstructive prostatic hypertrophy (BPH) were evaluated regarding the influence of prostatectomy on upper urinary tract function by means of [51Cr]EDTA clearance and gamma camera renography measurements. 25 patients were randomly allocated to transvesical and 34 patients to transurethral prostatectomy. At the 6-month follow-up a slight decrease in glomerular filtration rate (GFR) was seen in the total patient group. Residual renal activity 20 min following injection (A20) as well as half-peak time values showed upper urinary tract obstruction in 54% of the patients preoperatively, whereas dilatation of the upper urinary tract was demonstrated at i.v. pyelography in only 15%. Patients with renographic obstruction preoperatively had low GFR values compared with patients without obstruction. In patients with upper urinary tract obstruction, prostatectomy relieved the obstruction, even in the case of normal urography. In patients with normal upper urinary tract, a clinically insignificant decrease in GFR and increase in A20 and half-peak time was observed. No differences with regard to upper urinary tract function were seen on comparing transurethral with transvesical prostatectomy.