Treatment of urinary disorders after transurethral resection of benign prostatic hyperplasia depending on their causes

Tarasov N.I., Ivaschenko V.A.

It is known that 1/3 of patients saved persistent urinary disorders after transurethral resection of the prostate (TURP) for benign prostatic hyperplasia (BPH) . There is no differentiated approach to the diagnosis and treatment of this disorders in everyday practice beacause the standard treatment do not always lead to the desired result. The aim of this study was the choice of urinary disorders treatment after TURP for BPH.

We conducted a comprehensive study 120 patients after TURP including evaluation of symptoms, bacteriological, histological, and urodynamic and dopplerographic studies for investigation of the nature and causes of urinary disorders. These patients were divided into 6 groups (20 persons in each group), depending from the treatment of urinary disorders: 1 – alpha blocker (α-AB); 2 – the M-Cholinolytic (M-ChL); 3 – α-AB+M-ChL; 4 – α-AB+ transrectal microwave hyperthermia; 5 – α-AB + m-ChL + transrectal microwave hyperthermia. The control (6-th group) included patients aer TURP, whom were given only antibiotic therapy. A complex survey to assess the effectiveness and the long-term results of the treatment was carried out twice – at 6 month after treatment, and 6 months after the end of treatment. We found that the treatment of urinary disorders caused by prostatitis, must be complex and include antibacterial therapy and transrectal microwave hyperthermia; it was established that it is necessary to use M-ChL for pathients with detrusor overactivity; and it is better to use α-AB and transrectal microwave therapy for reducing contractility of the detrusor (RCD); the best effect was obtained by a combination of α-AB and M-ChL with transrectal microwave hyperthermia in pathients with simultaneous HD and RCD.

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benign prostatic hyperplasia, transurethral resection of the prostate, lower urinary tract symptoms, detrusor contractility, detrusor overactivity, treatment, long-term results