CORRELATION BETWEEN PROSTATIC URETHRAL ANGLE WITH CLINICAL PARAMETERS AND BOO IN LUTS ASSOCIATED WITH BPH
##plugins.themes.bootstrap3.article.main##
##plugins.themes.bootstrap3.article.sidebar##
Abstract
Objective: We investigated the correlation of the PUA on clinical parameters and bladder outlet obstruction (BOO) in men with lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH). Material & Method: This study was performed between January to April 2011. A cross sectional analysis of 24 men with LUTS associated BPH aged > 50 years was performed. Patients underwent evaluation including International Prostatic Symptom Score (IPSS), transrectal ultrasonography, uroflowmetry, and pressure-flow study. Statistical analysis was performed to evaluate correlation of the PUA on clinical parameters and bladder outlet obstruction (BOO). Results: A total of 24 patients, aged 51 to 78 years were enrolled in this study. The mean value of total IPSS, prostate volume, PUA, and Qmax was 22 (range 7-35), 34,4 cm3 (range 21–70 cm3), 37,3° (range 25°–55°), and 10,5 mL/s (range 4,2–17,9 mL/s), respectively. Pearson’s correlation analysis showed that PUA was not significantly correlated with IPSS (p = 0,117), Qmax (p = 0,434), total prostate volume (p = 0,213). Patients with increased PUA (PUA > 35°) had higher incidence and degree of BOO (p < 0,05). Conclusion: PUA may be one method to assess the presence of BOO in men with LUTS associated BPH. Our investigation suggest that PUA may help in the treatment of individuals by better predicting their likely classification from a pressure-flow study.Keywords: Prostatic urethral angle, benign prostatic hyperplasia, lower urinary tract symptoms, bladder outlet obstruction.
##plugins.themes.bootstrap3.article.details##
Roehrborn CG, McConell JD. Etiology, patophysiology, and natural history of benign prostatic hyperplasia. In Walsh PC, Retik AB, Vaughan ED Jr, Wein A (eds). Campbells-Walsh Urology. 9th ed. Philadelphia: WB Saunders. 2007; 86: 2727-38.
Nordling J, Artibani W. Pathophysiology of the urinary bladder obstruction and aging. In Chatelain C, Denis L (eds). Benign Prostate Hyperplasia. 5th ed. United Kingdom: Plymbrige; 2001. p. 109-57.
Blaivas JG. Multichannel urodynamic studies in men with benign prostatic hyperplasia. Indications and Interpretation. Urol Clin North Am. 1990; (17): 543-52.
Abrams P, Griffiths DJ. The urodinamic assessment of lower urinary tract symptoms. In Chatelain C, Denis L (eds). Benign Prostate Hyperplasia. 5th ed. United Kingdom: Plymbrige; 2001. p. 227-72.
Belal M, Abrams P. Noninvasive methods of diagnosing bladder outlet obstruction in men. Part 1: Nonurodynamic Approach. J Urol. 2006; 176: 22-28.
McNeal JE. The prostate and prostatic urethra: A morphologic synthesis. J Urol.1972; 107: 1008–16.
Brooks JD. Anatomy of the lower tract and male genitalia. In Walsh PC, Retik AB, Vaughan ED Jr, Wein A (eds). Campbells-Walsh Urology. 9th ed. Phliladelphia: WB Saunders. 2007; 2: 56-68.
Cho KS, Kim J, Choi YD, Kim JH, Hong SJ. The overlooked cause of benign prostatic hyperplasia: Prostatic urethral angulation. Medical Hypotheses. 2008; 70: 532-5.
McConnell JD, Abrams P. Evaluation and treatment of LUTS in older men: Male urinary tract dysfunction evaluation and management. 6th International Consultation on New Development in Prostate Cancer and Prostate Disease; 2005.
Kirby R, Lepor H. Evaluation and nonsurgical management of benign prostatic hyperplasia. In: Walsh PC, Retik AB, Vaughan ED Jr, Wein A (eds). Campbells-Walsh Urology. 9th ed. Phliladelphia: WB Saunders. 2007; 87: 2766-802.
Schafer W, Abrams P, Liao L. Good urodynamic practices: Uroflowmetry, filling cystometry, and pressure-flow studies. Neurourol Urodyn. 2002; 21: 261-74.
Hyeon J, Ko DW, Cho JY, Oh SJ. Correlation between prostatic urethral angle and bladder outlet obstruction index in patients with lower urinary tract symptoms. Urology. 2010; 75(6): 1467-71.
Mirone V, Imbimbo C, Sessa G, Palmieri A, Longo N, Granata AM, et al. Correlation between detrusor collagen content and urinary symptoms in patients with prostatic obstruction. J Urol. 2004; 172: 1386–9.
Gerstenberg TC, Andersen JT, Klarskov P. High flow infravesical obstruction in men: Symptomatology, urodynamics and the results of surgery. J Urol. 1982; 127: 943-5.
Chancellor MB, Blaivas JG, Kaplan SA, Axelrod S. Bladder outlet obstruction versus impaired detrusor contractility: The role of outflow. J Urol. 1991; 5: 810-2.
Cho KS, Kim J, Choi YD, Kim JH, Hong SJ. Relationship between prostatic urethral angle and urinary flow rate: Its implication in benign prostatic hyperplasia pathogenesis. Urology. 2008; 71(5): 858-62.