Urodynamic parameters in patients with benign prostatic hyperplasia before surgery

Introduction. Besides directly contributing to the pathogenesis of lower urinary tract symptoms, bladder outlet obstruction due to benign prostatic hyperplasia may lead to lower urinary tract dysfunction such as detrusor overactivity and decreased bladder contractility. Materials and methods. The analysis of urodynamic parameters of patients who underwent surgical treatment of prostatic hyperplasia was performed at the University Clinic of Urology of the Pirogov Russian National Research Medical University. A total of 340 patients who underwent urodynamic study (UDI) were included in the study. The following urodynamic parameters were assessed: presence or absence of detrusor overactivity (DO); maximum cystometric capacity; presence or absence of decreased bladder contractility; in patients who were able to undergo the pressure-flow study, the infravesical obstruction index and contractility index were calculated. Results. Of 340 patients who were indicated for surgical treatment of BPH, concomitant detrusor overactivity was noted in 84,1% of patients. Concominant detrusor underacrivity was found in 123 (36,4%) patients and only 19 (6%) patients had no significant impairment of detrusor function. Comparing patients with and without detrusor overactivity, a significant difference was found in the ratio of the severity of lower urinary tract symptoms (IPSS 23,9±6 vs 20±7,7, p<0.001), the bladder outlet obstruction index (72,6±33,2 vs 57,4±26,4, p=0,005) and functional bladder capacity (207,6±98,1 vs 355±123,5, p<0,001). When comparing patients with detrusor underactivity and normal contractility, a significant difference was revealed in the ratio of the severity of storage symptoms (10,4±2,9 vs 9,4±3,3), bladder capacity (276,3±134 vs 205,3±94,2), which is associated with a greater rate of detrusor overactivity in patients with BPH and the bladder outlet obstruction index (49,7±19,1 vs 82,2±32,8). Conclusions. These observations demonstrate the significant prevalence of concomitant bladder dysfunction, as well as the relationship of these disorders with lower urinary tract symptoms and urodynamic parameters.