Can intravesical prostatic protrusion predict bladder outlet obstruction even in men with good flow?

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• 作者：Alvin Lee^a ; Han Jie Lee^a ; Kok Bin Lim^b ; Hong Hong Huang^a ; Henry Ho^a ; ^{henry.ho.s.s@sgh.com.sg" class="auth_mail" title="E-mail the corresponding author} ; Keong Tatt Foo^a
• 关键词：Male ; Prostate hyperplasia ; Pathology ; Ultrasonography ; Urinary bladder ; Urodynamics
• 刊名：Asian Journal of Urology
• 出版年：2016
• 出版时间：January 2016
• 年：2016
• 卷：3
• 期：1
• 页码：39-43
• 全文大小：527 K

文摘

Men with benign prostate hyperplasia (BPH) with good urinary flow may still have bladder outlet obstruction (BOO). Intravesical prostatic protrusion (IPP) has been shown to be able to predict BOO. We aim to investigate the use of IPP to predict BOO in men with good urinary flow.

Methods

One hundred and fourteen consecutive men (>50 years old) presenting with lower urinary tract symptoms suggestive of BPH were recruited in 2001 and 2002. They were evaluated with serum prostate specific antigen (PSA), uroflowmetry and transabdominal ultrasound measurement of IPP and prostate volume (PV). Pressure-flow urodynamic studies were performed on all men and BOO was defined by BOO index > 40. Men with Q_max ≥ 12.0 mL/s were considered to have good flow.

Results

Among the 114 men, 61 patients had good urinary flow. Their median age, PV and Q_max were 66 years, 32.9 mm³ and 14.5 mL/s respectively. 14/61 (23.0%) patients had BOO and their distribution of IPP were as follows: Grade 1 – 0/20 (0%) obstructed, Grade 2 – 6/22 (27.3%) and Grade 3 – 8/19 (42.1%). Sensitivity of Grade 2/3 IPP for BOO was 100% while specificity of Grade 3 IPP was 76.6%. The area-under-curve (AUC) for IPP was greater than that for PV (0.757 vs. 0.696).

Conclusion

Even in men with good flow, high grades of IPP were more likely to have BOO and hence, may be a useful adjunct to predict BOO.