Incomplete bladder emptying even after prostatectomy were not uncommonly anticipated in patients with benign prostate hypertrophy(BPH) who had episodes of acute urinary retention. This may be related to impaired contractility of detrusor muscle
secondary to deceased blood flow to the bladder and overstretching of detrusor muscle caused by overdistension of bladder. We measured detrusor contractility in 41 patients with BPH who had episodes of urine retention (Group A) and 77 patients
with
BPH
without urine retentio .Also, follow up uroflowmetry were taken for 25 patients of group A and 40 patients of group B in 30-50 days after prostatectomy, Results were as follows ;
1. On filling cystometry, first sense of fill, urge sense to void, maximum cystometric capacity and compliance were not significantly were 23 cases(56%) in group A, 38 cases(49%) in group B.
2. On pressure-flow study, maximum detrusor voiding pressure was 32.5±4.13cmH₂O in group AQ and 50.27±2.4cmH2O in group B OP<0.01)
Peak flow rate (Qmax) and voided volume were 4.1±0.7ml/sec, 76.1±12.7ml in group A and 8.6±0.65ml/sec, 176.1±16.7 ml/in group B respectively (P<0.01, P<0.01). Residual urine was 256.5±24.3 ml in group A and 111.6±14.7 ml in group B (P<0.01)
3. On postoperative follow up urofiowmetry, voided voided volume and Qmax were increased compared to preoperative value in group A but still lower than those in group B (P<0.05, P<0.05).
4. The number of patients who didn't show show any improvement of voiding symptoms after surgery were 17 on group A and 11 on group B. Impaired detrusor contractility was present in 25 of 41 cases (61%) of group A and 10 of 71 cases (13%)of
group
Bon
urodynamic diagnosis, Conclusively, in patients with BPH who had episodes of urine retention, preoperative pressureflow study to recognize impaired detrusor contractility would be helpful in anticipating incomplete bladder emptying after prostate
surgery and considering other forms of ancillary therapy.
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