OBJECTIVETo analyze the correlation of the length and volume of intravesical prostatic protrusion (IPP) with bladder outflow obstruction (BOO) in patients with BPH and to find a simple method for the diagnosis of the disease.

METHODThe length and volume IPP were measured by transrectal ultrasound for 87 patients with BPH, the diagnosis of BOO was made by urodynamic tests and the correlation of the length and volume of IPP with BOO was analyzed, and reanalyzed 3 months after oral medication of a-blocker. The length and volume of IPP were measured again during the operation in 54 of the cases to confirm the ultrasound findings.

RESULTSBOO was diagnosed in 51 of the patients. The coefficient of correlation between the length of IPP and BOO and that between the volume of IPP and BOO were 0.53 and 0.47 (P < 0.01). Not considering the dynamic factors, they were 0.69 and 0.62 (P < 0.01), respectively. BOO was confirmed in patients with the length of IPP > 1.0 cm or the volume > 1.5 ml. There was no significant difference between the results of transrectal ultrasound and the findings during the operation concerning the length and volume of IPP (P > 0.05).

CONCLUSIONThere is a close correlation between the length and volume of IPP and BOO, which can be conveniently applied to the diagnosis of BOO in BPH patients.

Aged ; Humans ; Male ; Middle Aged ; Prostate ; diagnostic imaging ; Prostatic Hyperplasia ; complications ; diagnostic imaging ; Ultrasonography ; Urinary Bladder ; diagnostic imaging ; Urinary Bladder Neck Obstruction ; diagnosis ; etiology ; physiopathology ; Urodynamics

OBJECTIVETo investigate the changes and its clinical significance of ultrasound evaluated bladder wall weight (UEBW) pre and after surgery in patients with benign prostatic hyperplasia (BPH).

METHODSThe clinical data of 63 patients of benign prostatic hyperplasia and 30 of contrast control were studied. The bladder wall weight was calculated by subtracting the volume of sphere represented by the urine volume inside the bladder from the volume of the sphere representing the whole bladder (sphere with a radius = internal radius + bladder wall thickness). Bladder outlet obstruction (BOO) and bladder function was evaluated by urodynamic studies. Of the 63 patients with BPH, UEBW was (97 +/- 54) g, while the control group was only (41 +/- 14) g. UEBW was found to be significantly correlated with LinPURR grade (R = 0.47, P < 0.01) and positive residual urine volume (R = 0.48, P < 0.01), and it was negatively correlated with Qmax (R = -0.52, P < 0.01) and detrusor contraction strength (presented as WF, R = -0.4, P < 0.05).

RESULTSA significant difference was found between the UEBW pre and after surgery [(99 +/- 50) g vs. (56 +/- 21) g, t = 5.05, P < 0.01)]. UEBW decreased 43.68%, and IPSS score decreased 16.81 point, while Qmax increased 8.38 ml/s.

CONCLUSIONAs an non-invasive methods, measurement of bladder wall weight appears to be a useful marker in evaluating status before operation and in monitoring the effect of surgery for patients with BPH.

Humans ; Male ; Middle Aged ; Organ Size ; Prostatic Hyperplasia ; complications ; pathology ; surgery ; Time Factors ; Transurethral Resection of Prostate ; Treatment Outcome ; Urinary Bladder ; pathology ; physiopathology ; Urinary Bladder Neck Obstruction ; diagnosis ; etiology ; Urodynamics

The goal of this study was to evaluate the clinical and urodynamic features in Korean men with lower urinary tract symptoms (LUTS) and to determine non-invasive parameters for predicting bladder outlet obstruction (BOO). Four hundred twenty nine Korean men with LUTS over 50 yr of age underwent clinical evaluations for LUTS including urodynamic study. The patients were divided into two groups according to the presence of BOO. These two groups were compared with regard to age, the results of the uroflowmetry, serum prostate-specific antigen (PSA) level, prostate volume, International Prostate Symptom Score (I-PSS), and the results of the urodynamic study. Patients with BOO had a lower maximal flow rate (Q(max)), lower voided volume, higher serum PSA level and larger prostate volume (P<0.05). BOO group had a significantly higher rate of involuntary detrusor contraction and poor compliance compared to the patients without BOO (P<0.05). The multivariate analysis showed that Q(max) and poor compliance were significant factors for predicting BOO. Our results show that Q(max) plays a significant role in predicting BOO in Korean men with LUTS. In addition, BOO is significantly associated with detrusor dysfunction, therefore, secondary bladder dysfunction must be emphasized in the management of male patients with LUTS.
Aged ; Humans ; Male ; Middle Aged ; Predictive Value of Tests ; Prostate-Specific Antigen/blood ; Republic of Korea ; Severity of Illness Index ; Urinary Bladder Neck Obstruction/complications/*diagnosis/physiopathology ; Urination Disorders/complications/*diagnosis ; *Urodynamics