Ahmad Nawaz, Mian Habib Alam, Sajjad Hussain.
Evaluation of AUA Prostatic Symptom Score and Urodynamic Studies as a Tool for Pre-Operative assessment and monitoring of operative outcome in patients with BPH, undergoing TURP.
J Coll Physicians Surg Pak Jan ;10(10):387-91.

This prospective study was conducted to assess the role of the American Urologist Association (AUA) prostatic symptom score and urodynamic studies in preoperative assessment and postoperative monitoring of benign prostatic hyperplasia patients undergoing TURP. Study included 25 consecutive patients with symptoms of prostatism but were not obstructed. The symptom score in our study decreased from 20.88 to 3.88 over a period of 6 weeks follow-up after TURP and this decrease was observed both in obstructive and irritative scores. The mean flow rate increased from 5.6 ml/sec (pre-operative) to 11.96 ml/sec at 2 weeks and 14.08 ml/sec at six weeks postoperatively. The mean pre-operative detrusor pressure at maximum flow had been 99.4±30.77 cm H20 and a decrease to 42.76±8.08 cm H20 was noted at 6 weeks after TURP. Pearson `r` test was applied to study the correlation between symptom scoring and different urodynamic parameters before and after TURP. An investigation for a inverse correlation in pre-operative symptom scoring and maximum urinary flow rate showed that only 23% change in flow rate may be explained by a linear correlation with pre-operative symptom scoring (Pearson r_-0.48 and r2=0.23). We could not find any significant correlation between vesical pressure at maximum flow and maximum flow rate pre-operatively as well as at 6 weeks postoperatively. Similarly, no significant correlation between pre-operative vesical pressure and obstructive symptom score (Pearson r2=0.01) irritative symptom scores (Pearson r2=0) and bladder capacity (Pearson r2=0.03) was found in our study. In this study we found that in BPH symptomatology and uroflowmeteric evidence of lower urinary tract obstruction are not closely related, thus subjective and objective evidence must be considered independently in selecting candidates for prostatectomy. The pressure/flow data at 2 weeks and at 6 weeks post TURP, when plotted on Abrams and Griffiths pressure/flow nomogram, revealed a trend of shifting of patients from obstructed to non-obstructed zones as period of follow-up increased.

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