Do BPH patients have neurogenic detrusor dysfunction?
BPH patients, particularly those>65 years of age, commonly have NDD. Multiple cerebral infarction (upper neuron disorder) and lumbar spondylosis (lower neuron disorder) might contribute to DO and UD, respectively. A uro-neurological assessment is important to select typical BPH patients for maximizing therapeutic benefit.
A one-stage procedure is only able to cure 2/3 of patients. In view of the tendency to progressive regression of often monstrous distensions during the neonatal period, first-line treatment should consist of a distal incision, followed, in the case of recurrent infections, by partial or total nephrectomy, while reserving the intravesical approach to cases with recurrent pyelonephritis. When this surgery is performed on older children or adolescents, the ureteroceles will be smaller with a lesser risk of sphincter damage.