Combined Cystometric, Sphincter Electromyographic and Uroflowmetric Studies Before and After Transurethral Resection of the Prostate

Abstract

Detrusor and urethral function was studied in 10 patients before and 3 mo. after transurethral resection of the prostate by means of flowmetry, and simultaneous gas cystometry and integrated sphincter electromyography. The patients had no clinical signs of neurological disease. Six had neurogenic exaggeration of the detrusor reflex in the preoperative studies. In 3 patients changes in the detrusor reflex were found postoperatively. Postural changes in detrusor reflex excitability were encountered preoperatively and postoperatively. The preoperative finding of detrusor hyperreflexia in the majority of the patients was ascribed to lesions in the detrusor reflex organization at 2 anatomical sites: a subclinical lesion of the cerebral circuits of the detrusor reflex control owing to arteriosclerosis and an increase of sensory detrusor-reflex triggering stimuli from the morphologically changed prostatic urethra. Diagnostic techniques for delineation of minimal cerebrospinal impairment and objective assessment of the sensory innervation of the urethra are needed.