PREOPERATIVE AND POSTOPERATIVE URODYNAMICS IN PATIENTS OF BENIGN PROSTATIC HYPERPLASIA (TRANSURETHRAL RESECTION OF PROSTATE VS. OPEN PROSTATECTOMY)

A comparative study was conducted in the Department of Surgery, Government Medical College, Jammu, from December, 2010 to November, 2011 for a period of one year. Aim of the study was to see the effects of surgeries of benign prostatic hyperplasia (TURP and open prostatectomy) on the urodynamic parameters and to statistically analyze and compare the urodynamic outcome of two surgeries. Patients selected for study were those undergoing either transurethral resection of prostate (TURP) or open prostatectomy for benign prostatic hyperplasia (BPH), whereas those excluded from the study were patients with nervous system disorders, unstable/overactive bladder, obstructive symptoms due to causes other than BPH and those who were not fit for general anaesthesia. Forty patients with prostate >50 grams, who fulfilled the inclusion criteria, were randomly and equally selected to undergo either transurethral resection of prostate (TURP) or open prostatectomy. Preoperative urodynamic study of the patients was done. Repeat urodynamic study of the patients was done at 3 weeks and 3 months after surgery. Then the differences in the preoperative and postoperative urodynamics were evaluated in two groups of patients. The mean maximum flow rate (in ml/sec) was more in TURP group at 3 weeks postoperatively but the difference was statistically non-significant. However, it was more in open prostatectomy group at 3 months postoperatively and the difference was statistically significant (p = 0.01). The mean average flow rate (in ml/sec) was more in TURP group at 3 weeks postoperatively but the difference was statistically non-significant. However, it was more in open prostatectomy group at 3 months postoperatively and the difference was statistically significant (p = 0.008). The mean maximum detrusor pressure (in cm H2O) was more in open prostatectomy group at 3 weeks postoperatively but the difference was statistically non-significant. However, it was more in TURP group at 3 months postoperatively and the difference was statistically significant (p = 0.0001). Open prostatectomy is an acceptable operation for the prostate size >50 grams. Higher peak flow rate improvement, average flow rate improvement and less detrusor pressure was evident in patients treated with open prostatectomy group. Open prostatectomy is a better procedure than transurethral resection of prostate as per as the udoynamic outcome is taken into consideration.