The Significance of Uninhibited Detrusor Contractions in Prostatism

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Abstract
In an attempt to identify preoperatively patients who will not benefit from prostatectomy, 84 patients with prostatism about to undergo transurethral resection of the prostate were evaluated prospectively with preoperative and postoperative symptom analysis and urodynamic examination, including cystometrograms. Of the patients, 67 were followed at 3 mo. and 54 again at 12 mo. Preoperatively, 65% of the patients had uninhibited detrusor contractions, while 38 had persistent postoperative uninhibited detrusor contractions at 3 mo. Patients in whom uninhibited detrusor contractions persisted postoperatively more often had unacceptable postoperative symptoms. Of the patients, 13% believed the symptoms to be the same or worse at 3 and 12 mo. The incidence of uninhibited detrusor contractions in these patients was 57 and 71%, respectively. While this finding suggests that persistent postoperative uninhibited detrusor contractions are associated with an unfavorable surgical outcome, which patients would have uninhibited detrusor contractions following prostatectomy could not be predicted by use of preoperative cystometric findings together with detailed symptom analysis. Thus, a role for preoperative cystometric screening of patients with prostatism could not be defined.

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