Objectives: To compare the benefits of transurethral resection of the prostate in urodynamically obstructed versus selected urodynamically unobstructed or equivocal men with severe lower urinary tract symptoms associated with benign prostatic enlargement.
Methods: In this case series study, men with lower urinary tract symptoms were selected if they met the study criteria and underwent the tests recommended by the International Scientific Committee on Benign Prostatic Hyperplasia. They also underwent urodynamic investigations. Men were included when transurethral resection of the prostate was selected as the treatment modality. Of the 132 included subjects, 93 could be re-evaluated 6 months after surgery.
Results: Of the 93 re-evaluated men, 59 were obstructed and 34 were unobstructed or equivocal. Both groups were similar with respect to age, symptoms, bother, benign prostatic hyperplasia-impact index, and quality of life. The quantified reductions in symptoms and bother in the unobstructed and equivocal men were about 70% of those reductions in the obstructed men. In the equivocal men, and even in the unobstructed men, a significant reduction with 40% of the urethral resistance occurred.
Conclusions: Transurethral resection of the prostate may be a good treatment alternative for unobstructed or equivocal men with severe lower urinary tract symptoms associated with prostatic enlargement, who opt for resection or who do not respond to or do not tolerate medical therapy.
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