하부요로증상/전립선비대증 환자에서 방광출구 폐색의 유무 및 방광 기능에 따른 경요도전립선절제술의 결과 및 만족도
The Outcome and Satisfaction of Patients with Lower Urinary Tract Symptoms/Benign Prostatic Hyperplasia following Transurethral Resection of the Prostate according to Urodynamic Obstruction and the Bladder Function
정윤석, 황태곤, 김준철,
소속 상세정보
정윤석 ( Jung Yun-Seok )
가톨릭대학교 의과대학 비뇨기과학교실
황태곤 ( Hwang Tae-Kon )
가톨릭대학교 의과대학 비뇨기과학교실
김준철 ( Kim Joon-Chul )
가톨릭대학교 의과대학 비뇨기과학교실
KMID : 0358320070480090965
Abstract
Purpose:We compared the clinical and urodynamic findings of patients suffering with lower urinary tract symptoms(LUTS)/benign prostatic hyperplasia(BPH) and who underwent transurethral resection of the prostate, and we tried to determine the effect of urodynamical obstruction and the bladder function on the result of this operation.
Materials and Methods:101 patients with LUTS/BPH were categorized in four groups based on the findings of the preoperative urodynamic study: 15(14.8%) patients without bladder outlet obstruction[(BOO(-)], 50 (49.5%), patients with BOO[(BOO(+)], 12 patients(11.8%) with BOO and with detrusor underactivity(BOO+DU), and 24 patients(23.7%) with BOO and with detrusor overactivity(BOO+DO). The outcomes and satisfaction were analyzed by the changes of the International Prostate Symptom Score(IPSS) and the quality of life(QoL) index before and after transurethral resection of the prostate(TURP), respectively.
Results:The Qmax was significantly high and residual urine was significantly low in group BOO(-). The PdetQmax was significantly high in group BOO(+) and also in the BOO+DO group. In group BOO(-), the decrease of the total IPSS was smaller than that noted in the other groups. There were significant decreases of the IPSS after TURP in groups BOO (+), BOO+DU and BOO+DO each voiding and storage subscore were decreased,but in group BOO+DO, the improvement was not as much as that in the other groups. The QoL was improved significantly in group BOO compared to the other groups.
Conclusions:Performing urodynamics preoperatively helps to predict the degree of symptom relief, and a higherbaseline BOO positively predicts the postoperative improvement of the IPSS and the QoL. The outcome of the BOO+DU group was satisfactory, but storage symptoms still existed for the BOO+DO group. (Korean J Urol 2007;48:965-970)
키워드
Prostatic hyperplasia;Urodynamics;Urinary Bladder neck obstruction;Transurethral resection of prostate
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