Ultrasonic measurement of bladder weight as a possible predictor of acute urinary retention in men with lower urinary tract symptoms suggestive of benign prostatic hyperplasia

Benign prostatic hyperplasia (BPH) is a common cause of morbidity in older men in developed countries. BPH causes lower urinary tract symptoms (LUTS) and occasionally results in such complications as acute urinary retention (AUR), urinary tract infection, and even obstructive uropathy. Although the development of medical treatments has reduced the role of surgery, prostatectomy remains a widely performed procedure. Epidemiology, risk factors, and pathophysiology are discussed. Diagnosis includes clinical features, history, physical examination, and laboratory testing. Management can include watchful waiting, medical treatment, surgery, and minimally invasive treatment. Management of AUR is also addressed. This review contains 4 figures, 10 tables, and 58 references. Keywords: Benign prostatic hyperplasia, lower urinary tract symptoms, urinary retention, incontinence, alpha blocker, 5α-reductase inhibitor, cystoscopy, transurethral intervention

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Benign Prostatic Hyperplasia

10.2310/im.1171 ◽

2019 ◽

Author(s):

Michael J Barry

Keyword(s):

Urinary Tract ◽

Benign Prostatic Hyperplasia ◽

Urinary Retention ◽

Lower Urinary Tract Symptoms ◽

Lower Urinary Tract ◽

Obstructive Uropathy ◽

Developed Countries ◽

Prostatic Hyperplasia ◽

Urinary Tract Symptoms ◽

Lower Urinary

Benign prostatic hyperplasia (BPH) is a common cause of morbidity in older men in developed countries. BPH causes lower urinary tract symptoms (LUTS) and occasionally results in such complications as acute urinary retention (AUR), urinary tract infection, and even obstructive uropathy. Although the development of medical treatments has reduced the role of surgery, prostatectomy remains a widely performed procedure. Epidemiology, risk factors, and pathophysiology are discussed. Diagnosis includes clinical features, history, physical examination, and laboratory testing. Management can include watchful waiting, medical treatment, surgery, and minimally invasive treatment. Management of AUR is also addressed. This review contains 4 figures, 10 tables, and 58 references. Keywords: Benign prostatic hyperplasia, lower urinary tract symptoms, urinary retention, incontinence, alpha blocker, 5α-reductase inhibitor, cystoscopy, transurethral intervention

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Elevated Tumor Necrosis Factor-α and Transforming Growth Factor-β in Prostatic Tissue are Risk Factors for Lower Urinary Tract Symptoms after Transurethral Resection of the Prostate in Benign Prostatic Hyperplasia Patients with Urinary Retention

The Open Urology & Nephrology Journal ◽

10.2174/1874303x01811010046 ◽

2018 ◽

Vol 11 (1) ◽

pp. 46-53 ◽

Cited By ~ 1

Author(s):

Gede W.K. Duarsa ◽

Anak A. G. Oka ◽

Sri Maliawan ◽

Doddy M. Soebadi ◽

Putu Astawa ◽

...

Keyword(s):

Risk Factors ◽

Urinary Tract ◽

Benign Prostatic Hyperplasia ◽

Urinary Retention ◽

Transurethral Resection ◽

Lower Urinary Tract ◽

Prostatic Hyperplasia ◽

Tnf Α ◽

Urinary Tract Symptoms ◽

Lower Urinary

Background: Lower Urinary Tract Symptoms (LUTS) after Transurethral Resection of the Prostate (TURP) occur in one-third of Benign Prostatic Hyperplasia (BPH) patients, may be caused by persistent prostatic inflammation and fibrosis. Objective: This study aims to evaluate the role of inflammation and fibrosis in pathological mechanism of LUTS among patients with BPH who underwent TURP by assessing their PSA, TNF-α, and TGF-β level. Design, Setting, and Participant: Data in this study were analyzed with the 2-way hypothesis. The study used odds ratio to define the risk factors of LUTS after TURP. The samples of the study are BPH patients after TURP aged 50-80 years old. Interventions: No intervention(s). Outcome Measurements and Statistical Analysis: The data analyzed using SPSS version 21.0 for Windows. Results and Limitations: There were 34 cases of LUTS and 42 controls without LUTS. We found that there were an increased levels of TNF-α (> 46.95 pg/ml) (OR 55.6, 95% Confidence Interval [CI] 11.1-278.4, p=0.00) and TGF-β (> 207.63 pg/ml) (OR 16.7, 95%CI 5.3-52.8, p=0.00). The result of multiple linear logistic regression analysis obtained equation Y= 0.033 x TNF-α + 0.031 x TGF-β. Population Attributable Risk (PAR) % TNF-α is 60%, PAR % TGF-β is 53%. Conclusion: Combination of elevated levels of TNF-α (>46.95 pg/ml) and TGF-β (>207.63) in prostate tissue is the risk factors for the occurrence of LUTS after TURP. Patient Summary: In this study, we enrolled 76 patients who were diagnosed with BPH and urinary retention. After TURP, there were 34 cases of LUTS and 42 controls without LUTS. We found that the levels of TNF-α and TGF-β between cases and controls were significantly different. We conclude that the combination of elevated levels of TNF-α and TGF-β in prostate tissue is the risk factors for the occurrence of LUTS after TURP.

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