![]() ![]() Written informed consent was taken from all patients for photographing, recording and also its use for scientific and medical education purposes. Institutional ethics clearance and approval of the research study protocol was obtained prior to the study. The study design was a prospective clinical research study, which was conducted in 172 consecutive men (aged >50 years) presenting with LUTS suggestive of BPH, from May 2016 to December 2018. PV, BWT, and IPP) and uroflowmetry for identifying BOO, by correlating them with the results of pressure–flow UDS. The main aim of the present study was to determine the utility of US-derived parameters (e.g. Therefore, it has been assumed that the measurement of this increase in BWT might be an indicator of the presence of BOO. from specimens obtained from patients with BOO and they found that there was an increased smooth muscle bulk, with or without interstitial collagen deposition. Ultrastructural changes in the bladder wall have been studied by Elbadawi et al. IPP can be measured accurately and non-invasively by TRUS and can predict voiding parameters for determining BOO in men who present with LUTS. The measurement of IPP is done by the vertical distance from the tip of the protruding prostate to the base of the bladder at the base of the prostate gland. IPP is a morphological change due to overgrowth of the prostatic median and lateral lobes into the bladder, and may lead to LUTS. In contrast, IPP has been found to correlate with BOO. The sensitivity and specificity for BOO with maximum urinary flow rate (Q max) has limited value depending on the threshold used. Of these, US estimation of the prostate size and PVR with uroflowmetry have been routinely used by most urologists the world over to determine the presence of BOO. Non-invasive methods to diagnose BOO include: symptom evaluation (IPSS), PSA measurement, ultrasonography (US)-derived parameters such as prostate volume (PV), bladder wall thickness (BWT), intravesical prostatic protrusion (IPP), and post-void residual urine volume (PVR). Invasive urodynamic studies (UDS) testing for P det are not routinely done in all patients with BPH. Clinically significant BOO is urodynamically characterised by increased detrusor pressure (P det) and a decreased urinary flow rate. To date, most of the evaluations have focussed mainly on the presence of voiding dysfunction rather than the cause. An assessment of clinically significant BOO has been done using different parameters. But the symptoms and obstruction do not entirely depend on the prostate’s size. Symptoms of BPH often result from benign prostatic obstruction (BPO) associated with benign prostatic enlargement. Prevalence of histological BPH increases with age, rising from ~40% in men aged 51–60 years to 90% by 81–90 years. In patients with BOO confirmed by the pressure–flow UDS, IPP Grade III was associated with a higher BOOI than was Grade I and II ( P < 0.001).Ĭonclusion: BWT, PV and PVR in conjunction with IPP are good predictors of clinically significant BOO due to BPH.Ībbreviations: AUC: area under the curve BOOI: BOO Index BPO, benign prostatic obstruction BWT, bladder wall thickness IPP: intravesical prostatic protrusion P det: detrusor pressure PV: prostate volume PVR: post-void residual urine volume Q max: maximum urinary flow rate QOL: quality of life ROC: receiver operating characteristic (TA)US: (transabdominal) ultrasonography UDS: urodynamic studiesīPH is a common benign disease of the prostate in ageing men. The IPP was a statistically significant predictor ( P < 0.001) of BOO compared with other variables in the initial evaluation. In all, 91 (55.49%) patients had BOO with a BOOI >40 and nine (5.49%) had equivocal BOO with a BOOI of 20–40. Men with a Q max of ≥12.0 mL/s were considered to have ‘good’ flow. Pressure–flow UDS were performed on all men and BOO was defined by a BOO Index (BOOI) >40. All had International Prostate Symptoms Score (IPSS), Quality-of-Life (QOL) index, uroflowmetry (including maximum urinary flow rate ) and PVR measured by transabdominal US. Patients and methods: In all, 164 patients presenting with lower urinary tract symptoms suggestive of benign prostatic hyperplasia (BPH), from May 2016 to December 2018, were included in this study. prostate volume, bladder wall thickness, post-void residual urine volume, and intravesical prostatic protrusion ) and uroflowmetry for identifying bladder outlet obstruction (BOO) by correlating them with the results of pressure–flow urodynamic studies (UDS). Objectives: To determine the utility of ultrasonography (US)-derived parameters (e.g. ![]()
0 Comments
Leave a Reply. |