Surgery for benign prostatic obstruction reliably improves voiding symptoms — weak stream, hesitancy, incomplete emptying — but storage symptoms such as urgency, frequency and nocturia respond less predictably and may persist or appear afterwards. Before listing, score both domains of the IPSS separately, use a frequency–volume chart where nocturia dominates, and consider urodynamics when storage symptoms predominate or the diagnosis is unclear. Tell men explicitly that they may still need bladder medication after a technically successful operation.
- Score IPSS voiding and storage subscores separately before surgery.
- Use a frequency–volume chart when nocturia is the main complaint.
- Consider urodynamics when storage symptoms dominate or obstruction is uncertain.
- Warn men that storage symptoms may persist after a successful operation.
Why it matters
Unmet expectations about storage symptoms are a common source of dissatisfaction after technically good surgery.
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