Postoperative efficacy of transurethral resection of the prostate (TURP) in treating benign prostatic hyperplasia combined with detrusor underactivity

This study investigated the postoperative efficacy of transurethral resection of the prostate (TURP) in patients with benign prostatic hyperplasia (BPH) and detrusor underactivity (DU). A total of 163 patients with BPH who underwent TURP at our hospital were analyzed. All the patients were diagnosed with DU via preoperative urodynamic tests. Based on the Schaefer nomogram assessment of detrusor contractility, patients were categorized into 3 groups: very weak (VW) (n = 30), weak minus (W-) (n = 46), and weak plus (W+) (n = 87). Postoperative outcomes, including International Prostate Symptom Scores (IPSS), quality of life (QOL) scores, maximum free urinary flow rate (fQmax), voided volume (VV), and post-void residual volume (PVR), were compared with preoperative values 2 weeks after catheter removal. Before surgery, there were no significant differences in IPSS, QOL, fQmax, VV, and PVR between the groups. Postoperatively, improvements were observed in all variables except for PVR in the VW and W- groups. Significant improvements in IPSS, QOL, and fQmax were noted compared to the preoperative values, but VV and PVR changes were not significant. Patients with normal detrusor strength showed greater improvements. TURP effectively enhanced the urinary flow and subjective urinary symptoms in most patients with BPH and DU. Effectiveness varies with detrusor muscle strength, and patients closer to normal strength experience better outcomes. If a ≥5 mL/s increase in fQmax post-TURP was deemed effective, the success rates were 50.0%, 69.6%, and 81.6% for the Valsalva voiding VW, W-, and W+ groups, respectively, with an overall rate of 72.4%. TURP is less effective when the bladder contractility index is <40 to 42.