Correlation Between Perfusion Of The Lower Urinary Tract And Detrusor Overactivity In Benign Prostatic Hyperplasia

Objective:By comparing with parametric variation between pressure- flow studies and transrectal colour Doppler ultrasonography (TRUS) before and half of year after transurethral resection of the prostatic(TURP), to elucidate if there was correlation between perfusion of the lower urinary tract and detrusor overactivity(DO).Methods:Fifty men with urodynamically confirmed DO and bladder outlet obstruction due to BPH had a TURP. Before and 3 months after TURP the International Prostatic Symptom Score(IPSS),quality of life(QoL)score were evaluated. Also, the lower urinary tract was evaluated using pressure-flow studies and transrectal colour Doppler ultrasonography to assess the vascular resistive index(RI) as a variable of the perfusion of the lower urinary tract. The patients were divided into 3 groups (obstruction,equivocal obstruction and unobstruction) according to the grade of pressure - flow.The outcome of transurethral prostatectomy were analyzed in each group with international prostate symptom score ,uroflowmetry, and residual urine volume, colour pixel density, resistive index.Results:Before TURP, Fifty patients were compared to the control group with international prostate symptom score, quality of lifescore, uroflow- metry, and residual urine volume, colour pixel density, resistive index there was a statistically significantly(P<0.001).After TURP were compared to before TURP in obstruction and equivocal obstruction with international prostate symptom score, quality of life score, uroflowmetry, and residual urine volume there was a statistically significantly(P<0.05),but in unob- struction here was no a statistically significantly(P>0.05).Before TURP were compared to after TURP no DO with international prostate symptom score, quality of life score, uroflowmetry, and residual urine volume ,colour pixel density, resistive index there was a statistically significantly (P<0.001). Before TURP were compared to after TURP DO with international prostate symptom score, quality of life score, uroflowmetry, and residual urine volume ,colour pixel density,resistive index there was a statistically signify- cantly(P<0.001). After TURP no DO were compared to the control with inter- national prostate symptom score, quality of life score there was a statistically significantly(P<0.001). After TURP DO were compared to the control with international prostate symptom score, quality of life score, uroflowmetry, and residual urine volume ,colour pixel density, resistiveindex there was a statistically significantly(P<0.001).Conclusions:Persistent DO in men after TURP seems to be associated with increased vascular resistance of the bladder vessels with subsequent reduced perfusion and hypoxia.