Pre- and Post-Prostatectomy Detrusor Wall Thickness and the Symptom Profile in Patients with Benign Prostatic Enlargement: A Prospective Review in Nigerian Men

Abstract

Background: The urinary bladder undergoes morphological and functional changes in patients with symptomatic benign prostatic enlargement (BPE). These detrusor changes reflect chronically increased intravesical pressure as a result of outlet obstruction. This study aims to determine the relationship between the Pre- and Post-op detrusor wall thickness (DWT), international prostate symptom score (IPSS) and duration of lower urinary tract symptoms (LUTS) in patients who had open simple prostatectomy (OSP). Method: This was a prospective study of a cohort of patients who had OSP for symptomatic BPE. The IPSS and symptom duration for each patient was noted. Each patient also had abdominal ultrasound scan with measurement of their DWT. Retropubic OSP was done for each patient. The detrusor wall thickness measured was also measured 12 weeks after the prostatectomy. Results:  Fifty-two patients completed the study; mean age was 66.37 ± 8.09 years. The median pre-operative IPSS was 28 (IQR = 13.75), and the median duration of symptoms was 24months (IQR = 37 months). The mean pre-operative DWT was 4.41 ± 1.38mm while the mean post-operative DWT was 2.16 ± 0.98mm. The pre-operative IPSS (p = 0.833) and duration of symptoms (p = 0.375) did not significantly correlate with the pre-operative DWT. There was significant reduction in the mean DWT (p < 0.001) and IPSS (p < 0.001) following prostatectomy. Conclusion:  DWT appears not to be significantly influenced by the severity or duration of LUTS. However, it reduced significantly following OSP with corresponding improvement in urinary symptoms.