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Urodynamic & Cystoscopy tests – then TURP?
I am scheduled for these two tests prior deciding for TURP (or TUIP or laser as KTP or HoLRP or??(*)). The rationale is that despite high doses (2x0.4 mg) of alpha blockers (tamsulosin) I still have a huge residual (~500-600 mL) and maybe a distended bladder. I might have developed a chronic retention and I am told TURP will help. But is it true?

My symptoms are mild and beside the asymptomatic retention I do not feel anything particular. My prostate is relatively small (32g) and PSA evolved “normally” for 1.8 to 2.3 in 8 years. If I knew TURP or similar will eliminate the problem I would be much more confident on the process and accept risks but I have doubts the problem with bladder would remain and I am not sure what you can do for it.

Did you go through the same process and doubts? Would TURP be really helpful in my condition? Were you happy of results? Thank you!

(*) e.g. refer to the212 EAU Guidelines http://www.uroweb.org/gls/pdf/12_Male_LUTS_LR%20May%209th%202012.pdf
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1711789 tn?1361311607
Hi there!

Yes, TURP may be useful with chronic urinary retention with BPH and over long term may be useful in preventing complications that could arise from the same. I would suggest discussing the pros and cons well in detail with your treating urologist before deciding on a management plan.
Hope this is helpful.

Take care!
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Thank you Dr. S. Kaul for your reply.

I passed the two tests which were recommended by my two different urologists. Prostate is 3 cm long (32 g) and is qualified as obstructive to the cystoscopy, while partially obstructive to the urodynamic test (pressure-flow study). Bladder is hypercompliant and they removed a severe residual of 900mL (!). Bladder detrusor muscle has typical configuration of trabeculations (indicative of muscular hypertrophy) but better than what can be thought.  I am told flow is not too bad and the partially obstructive result of the pressure-flow study might indicate a good chance of recovery, after surgery and at least partially, the bladder compliance. I am scheduled for bipolar TURP (B-TURP) by one of my urologists (he has a 2000+ cases experience). Surgery seems at this stage the best option as medicament to shrink (an already small) prostate will likely only defer the problem potentially making the bladder condition worse.

Do you also agree?
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I did my (bipolar) TURP two weeks ago and started recovery.
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