Bladder outlet obstruction index and maximal flow rate during urodynamic study as powerful predictors for the detection of urodynamic obstruction in women

2007 ◽  
Vol 26 (2) ◽  
pp. 247-253 ◽  
Author(s):  
Giovanni Luca Gravina ◽  
Alessia Mariagrazia Costa ◽  
Piero Ronchi ◽  
Giuseppe Paradiso Galatioto ◽  
Luana Gualà ◽  
...  
Keyword(s):  
Flow Rate ◽  
Bladder Outlet Obstruction ◽  
Outlet Obstruction ◽  
Urodynamic Study ◽  
Maximal Flow

scholarly journals Comparison of transurethral incision of the prostate and silodosin in patients having benign prostatic obstruction in terms of retrograde ejaculation

2017 ◽  
Vol 89 (1) ◽  
pp. 31 ◽  
Author(s):  
Basri Cakiroglu ◽  
Aydin Ismet Hazar ◽  
Orhun Sinanoglu ◽  
Ersan Arda ◽  
Sinan Ekici
Keyword(s):  
Flow Rate ◽  
Functional Outcomes ◽  
Bladder Outlet Obstruction ◽  
International Prostate Symptom Score ◽  
Prostate Volume ◽  
Outlet Obstruction ◽  
Retrograde Ejaculation ◽  
Maximal Flow ◽  
Benign Prostatic Obstruction ◽  
Transurethral Incision

Background: To compare the functional outcomes and retrograde ejaculation (RE) after transurethral incision of the prostate (TUIP) or silodosin in bladder outlet obstruction (BOO) secondary to a small prostate. Methods: Prospectively collected data from December 2011 through December 2014 of 192 LUTS patients having fertility concerns with prostate volume smaller than 40 ml receiving either TUIP or silodosin treatment were prospectively reviewed. The treatment outcomes were evaluated and compared. Results: TUIP was performed in 96 cases and silodosin 8 mg was prescribed in 96 cases. At 12<sup>th</sup> months after TUIP or continuous silodosin treatment, the decrease in mean International Prostate Symptom Score (IPSS) and postvoiding residual urine (PVR) and the improvement of mean maximal flow rate (Q<sub>max</sub>) were significant (p = 0.000). The improvement in IPPS and Qmax was significantly higher in TUIP group compared to silodosin group (p = 0.005, p = 0.000) with a lower rate of retrograde ejaculation (RE) in TUIP group. (11/96 vs 33/96) (p = 0.000) Conclusions: Both TUIP and silodosin ensures comparable improvement in PVR, IPSS and Q<sub>max</sub> with a lower rate of RE on the TUIP group in prostates weighing less than 40 grams suggesting that TUIP is a better choice in younger patiens seeking preservation of ejaculation with fertility concerns.

scholarly journals Correlation of intravesical prostatic protrusion with severity of lower urinary symptoms among patients with benign prostatic hyperplasia

2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Babatunde K. Hamza ◽  
Muhammed Ahmed ◽  
Ahmad Bello ◽  
Musliu Adetola Tolani ◽  
Mudi Awaisu ◽  
...  
Keyword(s):  
Flow Rate ◽  
Bladder Outlet Obstruction ◽  
Peak Flow ◽  
Prostate Volume ◽  
Outlet Obstruction ◽  
Peak Flow Rate ◽  
The Mean ◽  
Benign Prostate ◽  
Intravesical Prostatic Protrusion ◽  
Lower Urinary

Abstract Background Benign prostate hyperplasia (BPH) is characterized by an increase in the number of epithelial and stromal cells in the periurethral area of the prostate. Lower urinary tract symptoms (LUTS) often develop as a manifestation of bladder outlet obstruction (BOO) due to benign prostate enlargement. When the prostate enlarges, protrusion into the bladder often occurs as a result of morphological changes of the gland. Prostatic protrusion into the bladder can be measured with ultrasound as intravesical prostatic protrusion (IPP). There are studies that have shown IPP as a reliable predictor of bladder obstruction index (BOOI) as measured by pressure flow studies. IPP is thereby reliable in assessing the severity of BOO in patients with BPH. The severity of symptoms in patients with BPH can be assessed through several scoring systems. The most widely used symptoms scoring system is the International Prostate Symptoms Score (IPSS). The aim of this study is to determine the correlation of IPP with IPSS in men with BPH at our facility. Methods The study was a cross-sectional observational study that was conducted at the Division of Urology, Department of Surgery, in our facility. The study was conducted on patients greater than 50 years LUTS and an enlarged prostate on digital rectal examination and/or ultrasound. All consenting patients were assessed with the International Prostate Symptoms Score (IPSS) questionnaire, following which an abdominal ultrasound was done to measure the intravesical prostatic protrusion (IPP), prostate volume (PV) and post-void residual (PVR) urine. All the patients had uroflowmetry, and the peak flow rate was determined. The data obtained were entered into a proforma. The results were analyzed using Statistical Package for Social Sciences (SPSS) software package version 20. Results A total of 167 patients were seen during the study period. The mean age was 63.7 ± 8.9 years, with a range of 45–90 years. The mean IPSS was 18.24 ± 6.93, with a range of 5–35. There were severe symptoms in 49.1%, while 43.1% had moderate symptoms and 7.8% had mild symptoms. The overall mean IPP was 10.3 ± 8 mm. Sixty-two patients (37.1%) had grade I IPP, 21 patients (12.6%) had grade II IPP and 84 patients (50.3%) had grade III IPP. The mean prostate volume and peak flow rate were 64 g ± 34.7 and 11.6 ml/s ± 5.4, respectively. The median PVR was 45 ml with a range of 0–400 ml. There was a significant positive correlation between the IPP and IPSS (P = 0.001). IPP also had a significant positive correlation with prostate volume and post-void residual and a significant negative correlation with the peak flow rate (P < 0.01). Conclusion Intravesical prostatic protrusion is a reliable predictor of severity of LUTS as measured by IPSS, and it also shows good correlation with other surrogates of bladder outlet obstruction.

Bladder outflow obstruction

2017 ◽  
Author(s):  
Christopher R. Chapple ◽  
Altaf Mangera
Keyword(s):  
Flow Rate ◽  
Bladder Outlet Obstruction ◽  
Outlet Obstruction ◽  
Outflow Obstruction ◽  
Men And Women ◽  
Bladder Outflow Obstruction ◽  
Underlying Causes ◽  
Underlying Disorder ◽  
Complete History ◽  
Standard Tests

Bladder outflow obstruction (BOO) may occur due to several underlying causes in both men and women. It is not possible to diagnose bladder outlet obstruction on a history alone. It can be suspected based on the use of a flow rate but can only be diagnosed using pressure flow urodynamics. In this chapter, we discuss the aetiology, pathophysiology, and investigation of BOO. We emphasize the importance of a complete history, examination, and investigations with investigations such as flow rate and voiding cystometry, in addition to standard tests including urinalysis and a bladder diary. The management of the underlying disorder responsible for the BOO symptoms is discussed in the relevant chapters separately.

Bladder outlet obstruction in men with acute urinary retention: an urodynamic study

2013 ◽  
Vol 31 (5) ◽  
pp. 1045-1050 ◽  
Author(s):  
Maximilian Rom ◽  
Matthias Waldert ◽  
Hans Christoph Klingler ◽  
Tobias Klatte
Keyword(s):  
Urinary Retention ◽  
Bladder Outlet Obstruction ◽  
Acute Urinary Retention ◽  
Outlet Obstruction ◽  
Urodynamic Study

1219: The Effect of Terazosin on Functional Bladder Outlet Obstruction in Women: A Urodynamic Study

2005 ◽  
Vol 173 (4S) ◽  
pp. 331-331
Author(s):  
Thomas M. Kessler ◽  
Urs E. Studer ◽  
Fiona C. Burkhard
Keyword(s):  
Bladder Outlet Obstruction ◽  
Outlet Obstruction ◽  
Urodynamic Study

Urodynamic study for distinguishing multiple system atrophy from Parkinson disease

Neurology ◽  
2019 ◽  
Vol 93 (10) ◽  
pp. e946-e953 ◽  
Author(s):  
Jung Hyun Shin ◽  
Kye Won Park ◽  
Kyeong Ok Heo ◽  
Sun Ju Chung ◽  
Myung-Soo Choo
Keyword(s):  
Multiple System Atrophy ◽  
Parkinson Disease ◽  
Sensitivity And Specificity ◽  
Flow Rate ◽  
Detrusor Overactivity ◽  
Urodynamic Study ◽  
Maximal Flow ◽  
Postvoid Residual ◽  
Pressure Flow Study ◽  
Flow Study

ObjectiveTo evaluate the differences in urodynamic findings between multiple system atrophy (MSA) and Parkinson disease (PD) and to identify the differential diagnostic ability of urodynamic study.MethodsWe reviewed patients with MSA or PD who underwent urodynamic studies between January 2011 and August 2018. Patients with probable MSA and PD determined by movement disorder specialists at our center were included. Patients with alleged MSA or PD from outside hospitals, atypical or secondary parkinsonism, and any history of pelvic operation or radiation therapy were excluded.ResultsA total of 219 patients, 107 with MSA (male:female 50:57) and 112 with PD (male:female 57:55), were included. Patients with MSA had shorter disease duration and were referred for urologic evaluation earlier (p < 0.001). Detrusor overactivity and associated urine leakage were prominent in PD (p < 0.001). Patients with MSA showed lower maximal flow rate (4.0 ± 5.8 vs 9.1 ± 8.3 mL/s, p < 0.001) and larger postvoid residual (290.8 ± 196.7 vs 134.0 ± 188.1 mL, p < 0.001) with decreased compliance (44.9% vs 10.7%, p < 0.001) and impaired contractility (24.9 ± 33.8 vs 65.7 ± 51.1, p < 0.001). Postvoid residual from a pressure-flow study had the highest sensitivity and specificity (74.8% and 75.9%), followed by detrusor pressure at maximal uroflow (72.6% and 70.5%), bladder contractility index, and postvoid residual from uroflowmetry (71.0% and 70.5%, respectively).ConclusionsPatients with MSA showed lower maximal flow rate, larger postvoid residual with decreased compliance, and impaired contractility, whereas patients with PD had higher incidence of detrusor overactivity and associated leakage. For differential diagnosis, postvoid residual from a pressure-flow study provided the best sensitivity and specificity.Classification of evidenceThis study provides Class III evidence that urodynamic measures can distinguish patients with MSA from those with PD.

scholarly journals Change of Detrusor Contractility in Patients with and without Bladder Outlet Obstruction at Ten or More Years of follow-up

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Sheng-Fu Chen ◽  
Cheng-Ling Lee ◽  
Hann-Chorng Kuo
Keyword(s):  
Flow Rate ◽  
Bladder Outlet Obstruction ◽  
Outlet Obstruction ◽  
Maximum Flow ◽  
Maximum Flow Rate ◽  
Men And Women ◽  
Detrusor Contractility ◽  
Before And After ◽  
Voided Volume

AbstractTo analyze the change of detrusor contractility by investigating urodynamic characteristics with long term follow-up. This study retrospectively reviewed 166 lower urinary tract symptoms patients without bladder outlet obstruction (BOO) and 63 patients with BOO who underwent repeated urodynamic studies at the first time and more than 10 years later. The urodynamic parameters, bladder contractility index (BCI), and BOO index (BOOI) were compared before and after. As time goes by, detrusor pressure at maximum flow rate (PdetQmax) significantly decreased and post-void residual (PVR) volume significantly increased in both men and women. Full sensation, urge sensation, voided volume, and BCI significantly decreased. We also compared men with and without BOO, PdetQmax, maximum flow rate (Qmax), voided volume, and BCI all significantly decreased in both groups without difference. PVR increased greater in men with BOO after >10 years significantly (p = 0.036). Women with detrusor overactivity (DO) under antimuscarinic showed no significant BCI change compared to patients without DO (p = 0.228). Detrusor contractility decreases in men and women after >10 years of follow-up. However, this finding suggests that patients with BOO or DO under adequate medical treatment, detrusor contractility is not aggravated over 10 or more years of follow-up.

scholarly journals Comparison of Penile Cuff Test and Conventional Urodynamic Study Prior to Photoselective Vaporization of Prostate for Benign Prostate Hyperplasia Using a 120 W GreenLight High Performance System Laser

2020 ◽  
Vol 9 (4) ◽  
pp. 1189
Author(s):  
Kang Sup Kim ◽  
Yong Sun Choi ◽  
Woong Jin Bae ◽  
Hyuk Jin Cho ◽  
Ji Youl Lee ◽  
...  
Keyword(s):  
Bladder Outlet Obstruction ◽  
Benign Prostate Hyperplasia ◽  
Outlet Obstruction ◽  
Urinary Flow ◽  
Urodynamic Study ◽  
Prostate Hyperplasia ◽  
Predictive Values ◽  
Number Of Patients ◽  
Photoselective Vaporization ◽  
Benign Prostate

Background: We compared the utility of the penile cuff test (PCT) and the conventional urodynamic study (UDS) for the preoperative assessment of patients undergoing scheduled photoselective vaporization of the prostate (PVP) for benign prostate hyperplasia (BPH). Methods: Fifty-nine patients with voiding lower urinary tract symptoms (LUTS) underwent a simultaneous PCT and conventional UDS before PVP. The modified International Continence Society (ICS) nomogram was used to confirm bladder outlet obstruction after measuring maximum urinary flow rate and highest pressure at flow interruption. The PCT and UDS results, in terms of modified ICS nomogram predictions, were compared. Their sensitivities, specificities, and positive and negative predictive values were calculated. Results: Thirty-six patients were diagnosed as obstructed and 23 as non-obstructed/equivocal using the modified ICS nomogram during the PCT. All 36 of the first group were confirmed as obstructed by UDS. Of the 23 diagnosed as non-obstructed/equivocal by the PCT, 14 were confirmed to be non-obstructed by UDS, with nine diagnosed as obstructed. The PCT showed a sensitivity of 80% and a specificity of 100%. The positive and negative predictive values were 100% and 60.9%, respectively. Conclusions: In conclusion, despite our small number of patients, the PCT’s high sensitivity and specificity suggest that it may provide diagnostic information about bladder outlet obstruction before PVP for patients with voiding LUTS. Evidently, the PCT has the potential to be used for some patients as a screening alternative to invasive UDS.

Sign in / Sign up

Export Citation Format

Share Document