Would you recommend a bladder outlet procedure in a patient with a large obstructing prostate but little to no bladder function on urodynamics?

Given the large obstructing prostate, an outlet procedure may be reasonable despite little to no detrusor contractility. However, the expected benefit is less predictable than in patients with preserved detrusor function. The procedure may relieve obstruction, but it cannot restore bladder contractility, and the patient may continue to require intermittent catheterization or an indwelling catheter even after surgery. Existing data suggest that some patients with detrusor underactivity or even very poor contractility can regain voiding after de-obstruction but with variable success. The literature remains mixed, with variable definitions of detrusor underactivity, heterogeneous patient populations, different surgical approaches, and inconsis...