DETERMINATION OF INFRAVESICAL OBSTRUCTION IN COMPLEX ASSESSMENT OF RESULTS OF EXAMINATION IN PATIENTS WITH BENIGN HYPERPLASIA OF THE PROSTATE
https://doi.org/10.24884/1561-6274-2005-9-2-112-116
Abstract
THE AIM of the investigation was to increase reliability of the assessment of the presence and degree of infravesical obstruction (IVO) in patients with benign hyperplasia of the prostate (BHP) on the basis of common methods of urologic examination. PATIENTS AND METHODS. Eighty BHP patients, mean age 58.2±2.1 years, were examined. The examination included the assessment of complains by the IPSS score, ultrasonic investigation with determination of the prostate size and amount of the residual urine and urodynamic investigation including uroflowmetry and miction cystometry («pressureflow» investigation). RESUILTS. The assessment of BHP symptoms, the prostate size, quantity of residual urine and maximal volume rate of urination can not always speak of peculiarities of the disturbances of functions of the lower urinary pathways in BHP patients, the presence and degree of IVO included. So, a formula was developed for a complex estimation of clinical indices for more exact and reliable determination of the IVO presence: D1 =0.818× Smax +0.0006×Smin+0.215× Qmax 0.478× Qaver , where D1 is the discriminant function; Smax is the maximal linear size of the prostate; Qmax is the maximal volume rate of urination and Qaver is the average rate of urination.In D1 ≥2.85 IVO can be determined, in D1<2.85 IVO is more likely to be absent. CONCLUSION. The developed formula allows a more exact and reliable diagnosis of IVO in BHP patients as compared to the isolated assessment of clinical indices.
About the Author
R. E. Amdy
Санкт-Петербургский государственный медицинский университет им. акад. И. П. Павлова
Russian Federation
Russian Federation
References
1. Homma Y. Pressureflow studies in benign prostatic hyperplasia: to do or not to do for the patient? Br J Urol Int 2001; 87 (1): 1923
2. Mashino R, Kakizaki H, Ameda K et al. Detrusor instability with equivocal obstruction: A predictor of unforable symptomatic outcomes after transurethral prostatectomy. Neurourol Urodynam 2002; 21 (5): 444449
3. Hakenberg OW, Pinnock CB, Marshall VR. Preoperative urodynamic and symptom evaluation of patients undergoing transurethral prostatectomy : analysis of variables relevant for outcome. Br J Urol Int 2003; 91 (4): 375 379
4. Porru D, Jallous H, Cavalli V et al. Prognostic value of a combination of IPSS, flow rate and residual urine volume compared to pressureflow studies in the preoperative evaluation of symptomatic BPH. Eur Urol 2002; 41 (3): 246 249
5. Rodrigues P, Lucon AM, Campos Freire G, Arap S. Urodynamic pressure flow studies can predict the clinical outcome after transurethral prostatic resection. J Urol 2001; 165 (2): 499502
6. Blaivas JG, Appel RA, Leach G et al. Definition and classification of urinary incontinence : recommendations of the Urodynamic Society. Neurourol Urodynam 1997; 16 (3): 149151
7. Shafer W. Basic principles and clinical application of advanced analysis of bladder voiding function. Urol Clin North Am 1990; 17 (2): 553566
8. Abrams P. In support of pressure flow studies for evaluating men with lower urinary tract symptoms. Urol 1994; 44 (2): 153158
9. Chancellor MB, Rivas DA, Keeley FX et al. Similarity of the American Urological Association symptom index among men with benign prostatic hyperplasia, urethral obstruction not due to BPH and detrusor instability without bladder outlet obstruction. Br J Urol 1994; 74 (2): 200203
10. Rosier P, de la Rosette J. Is there correlation between prostate size and bladder outlet obstruction. World J Urol 1995; 13 (1): 913
11. Steele GS, Sullivan MP, Sleep DJ, Yalla SV. Combination of symptom score, flow rate and prostate volume for predicting bladder outflow obstruction in men with lower urinary tract symptoms. J Urol 2000; 164 (2): 344 348
12. Zhang P, Wu Z, Gao J. Influence of bladder outlet obstruction and detrusor contractility on residual urine in patients with benign prostatic hyperplasia. Chin Med J 2003; 116 (10): 15081510
13. Grino PB et al. Maximum urinary flow rate by uroflowmetry: automatic or visual interpretation. J Urol 1993; 149 (2): 339341
14. АльШукри СХ, Амдий РЭ, Горбачев АГ, Кузьмин ИВ. Оценка результатов урофлоуметрии. IX Всерос. съезд урологов. Материалы. М., 1997: 2425
15. Абоян ИА, Головко СЮ, Хитарьян АГ и др. Шкала диагностики инфравезикальной обструкции у больных с доброкачественной гиперплазией простаты. Урол и нефрол 1998; (6): 32 37
16. Van Venrooij GE, Boon TA. The value of symptom score, quality of life score, maximal urinary flow rate, residual volume and prostate size for diagnosis of obstructive benign prostatic hyperplasia: a urodynamic analysis. J Urol 1996; 155 (6): 20142018
17. Madersbacher S, Klinger HC, Djavan B et al. Is obstruction predictable by clinical evaluation in patients with lower urinary tract symptoms? Br J Urol 1997; 80 (1): 7277
18. Kuo HC. Clinical prostate score for diagnosis of bladder outlet obstruction by prostate measurements and uroflowmetry. Urol 1999; 54 (1): 9096
Review
For citations:
Amdy R.E. DETERMINATION OF INFRAVESICAL OBSTRUCTION IN COMPLEX ASSESSMENT OF RESULTS OF EXAMINATION IN PATIENTS WITH BENIGN HYPERPLASIA OF THE PROSTATE. Nephrology (Saint-Petersburg). 2005;9(2):112-116. (In Russ.) https://doi.org/10.24884/1561-6274-2005-9-2-112-116
Views:
738
Email this article 