Analysis The Urodynamic Parameters Of BPH With Detrusor Instability After TURP

Research BackgroundBenign prostatic hyperplasia (benign prostate hyperplasia, BPH) is one of the most common chronic diseases in elderly men, is most likely to lead to male urination disorders. With the extension of life expectancy and technology of diagnosis improved, the incidence of BPH in recent years showed a rising trend., Epidemiological investigation of information at home and abroad, BPH usually occurs in the first40years later, at the age of50～59age group the prevalence rate is about20%-30%, the prevalence rate of more than50%in the group of60years old to69years old, Aged80and over more than80%. Wu Nan and other statistical domestic city hospital affiliated to medical situation, found that BPH accounted for the disease constituent ratio has been as high as47%.Transurethral resection of the prostate(TURP) belongs to minimally invasiveoperation, has been used in the treatment of BPH more than70years, has become the gold standard for treatment of BPH. Urodynamic examination in patients with BPH in the reoperative, diagnosis, diseases, complications, operation mode, postoperative outcome plays an important role. International Advisory Committee on prostatic hyperplasia in BPH recommendation clearly, urodynamic test before operative mainly aims to clear whether bladder outlet obstruction, and to determine the location and degree of obstruction. Urodynamic examination is to distinguish between lower urinary tract obstruction is the only index of detrusor underactivity or induced by BOO, is considered the gold standard for the diagnosis of BOO. Urodynamic examination can also on detrusor overactivity, detrusor weak contractility and neurogenic dysfunction caused by frequent urination, dysuria, nocturia and provide evidence for differential diagnosis. In addition, through the analysis of urodynamic parameters, It can also be used to guide the prognosis: preoperative examination with high-pressure or low-pressure chronic urinary retention, and bladder impotent patients, Postoperative catheter should be retained for a period of time, so as to promote the recovery of bladder function; and the preoperative examination of unstable bladder seriously, there may be frequent phenomenon after a long time, some patients accompany with urinary incontinence.ObjectiveThe aim of this study is to provides the reference for the clinical treatment by urodynamic examination to BPH with detrusor instabi lity in patients after transurethral resection of the prostate, through the multiparameter comparison,observation of detrusor instability to improve the situation.Methods72BPH samples were collected from Urology surgical in the Fifth People’s Hospital of Ji’nan from January2012to June2013. These patients had no history of the following diabetes, neurological history; neurogenic bladder; with urethral stricture, repeated urinary tract infections or bladder stones; Taking5-a reductase inhibitors within2weeks before The urodynamic examination,a receptor blockers or other effects of bladder function;Detection of serum PSA>4ng/l before operation (exclude the possibility of prostate cancer). The research object of age53to87years old, mean age (69.37±7.12) years old. All of the cases were carried out urodynamic complete before surgery, after4months and6months after urodynamic parameters, the mean follow-up time of5.2months.Results1. Transurethral resection of the prostate were treated with On BPH patients with detrusor, The IPSS score by preoperative severe symptoms (score:26.92±5.13) reduced to mild symptoms after surgery (score:7.95±4.27), The QOL score by preoperative (5.76±1.22) reduced to postoperative(1.54±0.97). The differences were statistically significant (P<0.01), It Proved that the symptoms of BPH patients with detrusor instability of lower urinary was greatly improved after transurethral resection of the prostate,2. Transurethral resection of the prostate can improve the symptoms of BOO+patients (P<0.001). In the detrusor function, preoperative detrusor contractility in28patients with deficiency (W+and below),5cases of contractility hyperthyroidism (ST); in9cases patients with systolic ability is insufficient, the remaining patients contractility normal (N-or N+). Fisher exact probability test confirmed that the difference was statistically significant, showed better recovery of postoperative patients with detrusor function. It indicate that preoperative low compliant bladder in31cases, high compliance bladder in7cases; postoperative low compliant bladder in5cases, high compliance bladder in2cases by bladder function examination, statistically significant differences, bladder function of patients after operation has been improved.3. The urodynamic studies were carried out before and after operation4-6month, observation of BPH in combination with detrusor instability in patients with residual urine volume, maximum urine flow rate, initial urinary volume, maximum urine volume, maximum urine flow rate when the detrusor pressure, bladder compliance, detrusor instability occurrence rate and other indicators, in addition to the maximum urinary volume, the rest of the parameters were statistically significant differences in the before and after treatment (P<0.05).