M-cholinoblockers after transurethral resection of the prostate

A.V. Kuzmenko, V.V. Kuzmenko, T.A. Gyaurgiev

Burdenko Voronezh State Medical University

Benign prostatic hyperplasia (BPH) is one of the most common causes of lower urinary tract symptoms (LUTS) in elderly men. More than 30% of men older than 80 years require surgery which, however, do not completely relieve LUTS.

Aim: to assess the efficacy of M-cholinoblockers for BPH with LUTS persisting after transurethral resection of the prostate (TURP).

Patients and Methods: 60 patients with BPH who underwent TURP were enrolled in the study. The patients were subdivided into two groups (30 patients each). Group 1 patients received anti-inflammatory treatment for 10 days and were followed-up for 1 month. Group 2 patients were prescribed with anti-inflammatory treatment and fesoterodine for 1 month. Treatment efficacy was evaluated at day 3–5 after TURP (urinary catheter removal), in 1 month (day 30), 3 months (90 days), and 6 months (180 days) by completing voiding diary, I-PSS score, QOL score, uroflowmetry (peak urine flow rate, Q_max), adverse effect number, and acute urinary retention.

Results: at baseline, urination frequency was 12.6 and 12.7, urinary urgency 9.2 and 9.0, nocturia 5.2 and 5.3 daily in group 1 and group 2, respectively. Mean I-PSS score was 19.8 and 19.7, Qmax 6.5 ml/sec and 6.7 ml/sec, respectively. Fesoterodine prescribed in group 2 has provided significant (p < 0.05) positive outcomes by day 30 as demonstrated by more effective dysuria relief and increase in Qmax due to the increased effective bladder capacity. Quality of life has also improved as demonstrated by QOL score.

Conclusions: M-cholinoblockers (i.e., fesoterodine) in combination with classic therapy for LUTS after TURP are recommended. Our findings demonstrate that long-term use of these agents effectively and safely improves irritative symptoms.

Keywords: benign prostatic hyperplasia, transurethral resection, fesoterodine, lower urinar y tract symptoms, overactive bladder.

For citation: Kuzmenko A.V., Kuzmenko V.V., Gyaurgiev T.A. M-cholinoblockers after transurethral resection of the prostate. RMJ. 2019;11:12–14.