The Self-Administered International Prostate Symptoms Score (IPSS) Questionnaire of Kosovo Men with Benign Prostatic Hyperplasia

Background: Benign prostatic hyperplasia (BPH) has been a major health problem for aging males because of its related symptoms and complications. Although it is not a life-threatening condition, BPH has an adverse effect on a patient’s quality of life, as manifested in community and clinical trials. Aim: The aim of the study was the perception of patients in their symptomatology by comparing the place of residence and quality of life in living with HBP using the IPSS questionnaire. Materials and Methods: This was a prospectively designed study conducted at University Clinical Centre of Kosovo—Urology Clinic. The study was conducted from October 2020 to January 2021. The study in criteria was as follows: all patients who presented to the urology outpatient clinic with BPH, Lower Urinary Tract Symptoms (LUTS) and aged > 40 years. The exclusion criteria included the following cases: patients with uncontrolled diabetes (prostate-specific antigen > 4 ng/dL);patients with a history of transurethral resection of the prostate. Results: This study was carried out on 100 consecutive patients with HBP and LUTS attending. The largest proportion of patients 51% was in the 46 - 55 age group. Most patients were between 45 - 65 years of 51%. The largest number of them (52%) was with severe symptoms and 41% of them were with moderate symptoms. Comparing the three levels of IPSS and the quality of life of patients with HBP and LUTS, when asked how they would feel if they still had problems with urination, 22% said they felt upset, analyzing the categorization of patients according to IPSS: mild symptoms were Mean/SD (1.71. ± 1.113), moderate symptoms (2.9 ± 1.49) and severe symptoms (4.31 ± 1.27) p < 0.156. Statistical reliability of 64% p < 0.000 was in patients where they were interested in learning about any invasive option that would allow them to discontinue medication for LUTS. Conclusion: The IPSS is a valid instrument to assess the impact of BPH symptoms on health and quality of life due to urinary symptoms.

Benign Prostatic Enlargement, the International Prostate Symptoms Score and a Review of Other Symptom Scores

Benign prostatic hyperplasia (BPH) is the most common benign prostate disease in elderly men, and its incidence increases with age and is associated with lower urinary tract symptoms (LUTS). The international prostate symptoms score (IPSS) is the most common symptom score used to assess LUTS even though other symptom scores exist. This study aims to evaluate the LUTS of patients secondary to BPH presenting to the urology clinic of UPTH using the IPSS and to review other scoring systems. Materials and Methods: This was a prospective hospital based descriptive cross-sectional study carried out in University of Port Harcourt Teaching Hospital (UPTH). All adult male patients with LUTS secondary to BPE were given an IPSS questionnaire to fill. Another IPSS questionnaire was filled by the patient assisted by the researcher. The data were collated using Microsoft Excel 2016 version and they were analyzed using SPSS version 20. Results were presented in tables. Results: Sixty-nine (69%) patients had at least secondary level of education. Sixty-four (64%) could complete their questionnaire without any aid. The mean IPSS was 22.13 ± 6.34 as most patients presented with severe symptoms. The mean Quality of Life score was 4.60 ± 1.38. There was a significant positive correlation between Quality of Life and IPSS. Conclusion: A level of literacy is needed to complete the questionnaire. Most patients in our study presented late with severe symptoms and significant level of bother. Nocturia was the worst symptom.

Relationship between age and prostate size

In a community-based study, the relationship between age and human prostate size was investigated in a population of men between the ages of 40 and 70 years to determine the normal prostate increase curve equation. One thousand male volunteers were randomly recruited from the Shanghai community, and the length, width, height, volume of the transition zone （TZ） and the whole prostates were measured by transrectal ultrasound （TRUS）. Each volunteer was evaluated bythe International Prostate Symptom Score （IPSS）. Among those who completed the examination, the mean prostate parameters were all positively associated with increased age. There were statistically significant differences between each age group （P〈O.05）. The mean transition zone volume （TZV） had a higher increase rate with age than the mean total prostate volume （TPV）, indicating that the enlargement of the TZ contributed the most to the increase in TPV. While all prostate parameters were positively correlated with the IPSS, the strongest correlation was associated with the TZ length （TZL） and TZV. The growth curve equations for prostate width, height and length were also positively associated with increasing

Relationship between serum sex hormones levels and degree of benign prostate hyperplasia in Chinese aging men

Benign prostatic hyperplasia （BPH） is one of the most common medical conditions in middle aged and older men. This study investigated the relationship between serum levels of sex hormones and measures of BPH in the aging male population of China. Prostate symptoms were assessed as part of a free health screening program for men ~40 years of age. The examination included digital rectal examination, determination of serum prostate-specific antigen levels, International Prostate Symptom Score （IPSS） and transrectal ultrasonography. Serum levels of total testosterone （TT）, sex hormone binding globulin （SHBG）, free testosterone （FT）, luteinizing hormone （LH）, follicle-stimulating hormone （FSH）, prolactin （PRL） and estradiol （E2） were evaluated. The men also completed a health and demographics questionnaire and received a detailed physical examination. The final study population consisted of 949 men with a mean age of 58.9 years. Pearson correlation analysis indicated that there were significant correlations between age and levels of all sex hormones except TT, and between age and prostate volume （PV; r=0.243; P〈0.01） or IPSS （r=0.263; P〈0.01）. Additional significant correlations were found between IPSS and serum levels of LH （r=0. 112; P〈0.01） and FSH （r=0.074; P〈0.05）, but there were no significant correlations between sex hormone levels and PV. Multivariate linear regression analysis showed significant correlations between age and body mass index （BMI） with PV （P〈0.0001）. In addition, there was a significant correlation between age and PV with IPSS （P〈0.0001）. Serum sex hormone levels did not correlate with PV or IPSS. The effects of endocrine changes on measures of BPH in aging men require further investigation in longitudinal and multicenter studies that include oatients with all severities of BPH.

Is there a correlation between the outcome of transurethral resection of prostate and preoperative degree of bladder outlet obstruction？

To compare the impact of transurethral resection of prostate （TURP） on symptom scores and maximal flow rates （Qmax） in patients with equivocal bladder outlet obstruction （BOO） and definite BOO and to assess the relationship between the surgical outcomes and degree of preoperative BOO, we prospectively evaluated men with lower urinary tract symptoms and bladder outlet obstruction index （BOO1） greater than 20, who were refractory to conventional medical treatment and underwent TURP. Urodynamic evaluation, International Prostate Symptom Score （IPSS）, uroflowmetry, post-void residual volume （PVR） check and transrectal ultrasound were performed. 20〈B001〈40 was defined as equivocal BOO and BOO1 〉~40 as definite BOO. Changes of IPSS, Qmax, PVR and correlation analysis was performed between the degree of improvement of Qmax, subdomains of I PSS and BOO1. Fifty-four patients showed equivocal BOO and 80 patients showed definite BOO. Preoperatively equivocal BOO group and definite BOO group showed significant differences in maximal bladder capacity and prevalence of detrusor overactivity, whereas no difference was noted in prostate volume. Postoperatively both groups showed improvements in Qmax, obstructive （IPSSO） and irritative （IPSSI） subdomain of IPSS, but the degree of improvement in Qmax and IPSSI subdomain was statistically significantly greater in definite BOO group. The degree of improvement of Qmax and IPSSI showed weak correlation with preoperative BOO1. As a weak correlation was identified between preoperative degree of BOO and outcome of TURP, other factors other than BOO1 such as severity of patients＇ symptoms should be considered in deciding treatment modality.

Efficacy of Bladder Neck Incision (BNI) Versus Transurethral Resection of Prostate (TURP) in Management of Benign Prostatic Hyperplasia (BPH) Causing Obstruction: A Randomised Controlled Study

Objective: To compare the efficacy of bladder neck incision (BNI) with transurethral resection of prostate (TURP) in the treatment of patients with urinary obstruction caused by benign prostatic hyperplasia (BPH) on the basis of short term follow up of 4 months. Patient and Methods: The study was conducted in Department of General Surgery in Maulana Azad Medical College, New Delhi. 60 men with proven clinical diagnosis of BPH of size 30 grams and less presenting with symptoms of bladder outlet obstruction (BOO) were randomised prospectively to undergo either of the two operative modalities. Preoperatively size of the prostate, symptom scoring (IPSS), peak flow rate (Qmax) were assessed. Postoperatively and during 4 months follow up the following data were collected—operative time, catheterisation period, hospital stay, blood loss, Qmax and IPSS. Results: Preoperative parameters in both the groups showed no statistically significant differences with respect to prostate size, Qmax and IPSS Scoring. At 4 months follow up Qmax increased from (6.35 ± 4.49) to (16.41 ± 2.28) in TURP group and (4.51 ± 3.57) to (15.95 ± 2.58) in BNI group. IPSS decreased from 18.70 to 5.7 in TURP group and 18.90 to 6.00 in BNI group. All differences were statistically significant. There was a statistically significant difference in operative time, blood loss, hospital stay, catheterisation timing favouring BNI. Conclusion: TURP and BNI are equally effective in providing symptomatic improvement. BNI has an upper hand in reference to operative time, hospital stay, duration of catheterisation and blood loss.

经尿道前列腺等离子剜除术预后的影响因素分析

目的研究经尿道前列腺等离子剜除术(PKEP)预后的影响因素。方法选取2020年5月至2022年1月在自贡市第一人民医院行PKEP手术的148例良性前列腺增生患者作为研究对象,根据术后3个月患者的国际前列腺症状评分(IPSS)分为两组,将IPSS≥8分的患者纳入术后预后不佳组(59例),将IPSS≤7分的患者纳入预后良好组(89例),收集并统计两组患者间年龄、体重指数、基础疾病、术前IPSS评分、前列腺体积、术中剜除时间、出血量等数据,并将差异有统计学意义的指标进行二元logistic回归分析。结果术后3个月预后良好组的IPSS为(4.93±1.16)分,低于预后不佳组的(10.81±2.18)分,差异有统计学意义(P<0.05)。两组的游离前列腺特异性抗原(fPSA)、体重指数(BMI)、前列腺体积(PV)、剜除的前列腺质量、术前IPSS评分、剜除时间、出血量、最大尿流率(Q_(max))和糖尿病发生情况相比较,差异有统计学意义(P<0.05);糖尿病(β=0.516,OR=1.236,95%CI=1.106~2.539)、剜除时间(β=0.019,OR=1.023,95%CI=1.010~1.037)是前列腺剜除术后预后不佳的危险因素(P<0.05)。结论PKEP是一种有效的手术方式。糖尿病及剜除时间是经尿道等离子剜除术预后的危险因素。积极调控患者血糖,提高技术,缩短剜除手术时间,能够让患者获得更好的预后。

BPH合并前列腺炎患者IPSS与IL-8、COX-2水平相关性研究

目的:观察良性前列腺增生(BPH)合并前列腺炎患者国际前列腺症状评分(IPSS)与前列腺按摩液(EPS)和前列腺组织中炎症因子白介素-8(IL-8)、环氧化酶-2(COX-2)水平的相关性。方法:将80例拟行经尿道前列腺电切术(TURP)BPH患者,根据术后病理学诊断分为单纯性增生组(30例)和增生伴炎症组(50例),两组均于术前行IPSS评分、EPS中IL-8、COX-2含量测定,术后前列腺组织中IL-8、COX-2的水平测定,进行统计学分析。结果:增生伴炎症组EPS中IL-8和COX-2水平显著高于单纯性增生组[IL-8:(15.31±1.22)ng/ml vs(5.89±0.91)ng/ml,COX-2:(371.09±14.99)ng/ml vs(156.96±29.47)ng/ml,P均<0.01],前列腺组织中两组IL-8和COX-2水平差异也显著(0.15±0.00 vs 0.05±0.02,0.13±0.01 vs 0.07±0.01,P均<0.01),IPSS两组差异也有显著性[(25.60±5.03)分vs(18.47±4.97)分,P<0.01];单纯增生组中IPSS与EPS和组织中IL-8及COX-2的表达呈中度相关(r=0.712、0.699、0.623、0.731,P均<0.05);增生伴炎症组中IPSS与IL-8、COX-2的表达呈高度相关(r=0.819、0.879、0.798、0.855,P均<0.05)。结论:EPS中IL-8、COX-2水平能间接反映前列腺组织中IL-8、COX-2水平,通过检测患者EPS中IL-8、COX-2水平并结合临床症状可以初步判定BPH患者是否合并前列腺组织学炎症。

膀胱残余尿量测定联合IPSS初步筛查糖尿病神经源性膀胱

目的探讨2型糖尿病神经源性膀胱初步筛查的方法及可能的影响因素。方法选取2018年1~12月冀中能源峰峰集团有限公司总医院内分泌科住院的2型糖尿病男性患者209例,根据膀胱残余尿量不同分为A组(膀胱残余尿量<50 mL)125例,B组(膀胱残余尿量≥50 mL)84例。比较两组患者的前列腺体积、国际前列腺症状评分(IPSS),入院时随机血糖、糖化血红蛋白、舒张压、收缩压及糖尿病病程情况;采取多元线性回归分析上述观察指标对膀胱余尿量的影响;比较两组糖尿病病程、前列腺体积引起膀胱余尿量增多概率,Pearson检验分析膀胱余尿量与糖尿病病程、糖化血红蛋白及入院随机血糖的相关性。结果与A组比较,B组糖尿病病程长、前列腺体积增大、入院时血糖高(P <0.05),B组排尿问题评分显著高于A组,差异有统计学意义(P <0.05);糖尿病病程≥10年及前列腺体积≥30 mL的患者残余尿量≥50 mL人数显著增加(P <0.05);糖化血红蛋白、糖尿病病程、前列腺体积是膀胱残余尿量增多的危险因素(P <0.05);前列腺体积<30 mL时膀胱残余尿量的多少与糖尿病病程密切相关(r=0.289,P <0.05);前列腺体积增大(≥30 mL)时膀胱残余尿量与糖化血红蛋白、入院随机血糖密切相关(r=0.370、0.381;P <0.05)。结论膀胱余尿量测定联合IPSS可辅助早期筛查糖尿病神经性膀胱,方法简单易行,对于糖尿病病程长、合并前列腺体积增大患者,需及早干预、积极防治。

尿流动力学检查结合IPSS评分在分析BPH患者PVP术后疗效作用

目的:观察中、重度国际前列腺症状评分（IPSS）患者行经尿道选择性绿激光前列腺汽化术（PVP）手术后中期疗效,总结分析术后不良反应发生原因及处理方式,尝试使用IPSS评分评价术后治疗效果。方法:回顾分析2010年1月2012年12月160例IPSS评分大于16分并行PVP治疗的良性前列腺增生症（BPH）患者临床资料,分析其尿流动力学特点,观察手术时间、术中出血、术后留置尿管时间、IPSS、生活质量评分（QOL）、最大尿流率(Qmax)、剩余尿量（RUV）及并发症等指标。术后随访1224个月,总结分析术后不良反应发生原因及处理方式。结果:IPSS评分中度59例、重度101例,平均IPSS（26.5±6.8）分。上述患者均安全度过围手术期,手术时间30147 min,术中无输血病例,术后留置尿管时间25 d。术后IPSS、QOL、Qmax明显改善,RUV【30 ml。术后随访1224个月。随访期间32例患者术后下尿路症状缓解不满意。行尿流动力学检查及尿道镜检查提示:膀胱出口梗阻25例（其中22例前列腺腺体残留,3例膀胱颈口挛缩）,逼尿肌收缩乏力6例（其中假性排尿困难1例）,逼尿肌括约肌协同失调（DSD）1例。结论:PVP是一种治疗中、重度IPSS评分BPH患者的有效方式,手术操作相对简单、出血少、术后并发症少。IPSS评分可量化评估患者手术效果,尿流动力学检查可明确术后疗效不佳原因,评估膀胱功能和逼尿肌稳定性,为临床鉴别诊断、选择合理的治疗方案和估计预后提供依据,对提高疗效具有重要的临床意义。

良性前列腺增生患者前列腺体积与最大尿流率、IPSS的相关性研究

目的探讨良性前列腺增生（BPH）患者前列腺体积与最大尿流率、国际前列腺症状评分（IPSS）之间的相关性。方法选择2013年4月至2014年5月收治的BPH患者共150例作为研究对象,均行尿动力学检查、经直肠超声检查及IPSS,根据Qmax结果的不同分为A组（Qmax≤10 ml/s）91例、B组（Qmax=11~15 ml/s）38例、C组（Qmax〉15 ml/s）21例。结果 150例患者Qmax平均为（8.1±2.5）ml/s,TPV平均为（46.7±13.4）ml,TZV平均为（28.9±7.2）ml,IPSS评分平均为（23.5±6.4）分。B组TPV、TZV、IPSS评分低于A组,但比较差异无统计学意义（P〉0.05）,而C组TPV、TZV、IPSS评分明显低于A组,比较差异有统计学意义（P〈0.01）;C组TPV、TZV、IPSS评分低于B组,但比较差异无统计学意义（P〉0.05）。经Spearman相关性分析结果显示,Qmax与TPV、TZV呈显著负相关（P〈0.05）,IPSS评分与TPV、TZV呈显著正相关（P〈0.05）,Qmax与IPSS评分呈显著负相关（P〈0.05）。结论在良性前列腺增生患者中,前列腺体积与最大尿流率、IPSS明显相关,前列腺体积越大,患者最大尿流率越低,下尿路症状越严重。

经尿道前列腺等离子双极电切术与经尿道前列腺电切术治疗良性前列腺增生患者的效果比较

目的:比较经尿道前列腺等离子双极电切术(TUPKP)与经尿道前列腺电切术(TURP)治疗良性前列腺增生(BPH)患者的效果。方法:选取2020年1月至2023年2月该院收治的74例BPH患者进行前瞻性研究,按随机数字表法将其分为对照组与观察组各37例。观察组采用TUPKP治疗,对照组采用TURP治疗,比较两组手术相关指标水平、手术前后疾病相关指标[前列腺特异性抗原(PSA)、前列腺素E_(2)(PGE_(2))]水平、尿流动力学指标[膀胱顺应性(BC)、最大尿流率(Qmax)、残余尿量(PVR)]水平、前列腺症状[国际前列腺症状评分(IPSS)]和术后并发症发生率。结果:观察组手术时间、导管留置时间、膀胱冲洗时间、住院时间均短于对照组,术中出血量少于对照组,差异有统计学意义(P<0.05);术后7 d,两组PSA、PGE_(2)水平均低于术前,且观察组低于对照组,差异有统计学意义(P<0.05);术后3个月,两组BC、Qmax水平均高于术前,且观察组高于对照组,两组PVR水平均低于术前,且观察组低于对照组,差异有统计学意义(P<0.05);两组IPSS评分均低于术前,且观察组低于对照组,差异有统计学意义(P<0.05);两组术后并发症发生率比较,差异无统计学意义(P>0.05)。结论:TUPKP治疗BPH患者可降低手术相关指标、疾病相关指标水平和前列腺症状评分,改善尿流动力学指标水平,其效果优于TURP治疗。

IPSS-V/S在TUVP术后下尿路症状评估的临床价值

目的:探讨国际前列腺症状评分的排尿期/储尿期评分比值(international prostatic symptom score-voiding/storage subscore ratio,IPSS-V/S)在经尿道前列腺汽化电切术(transurethral electrovaporization prostatectomy,TUVP)术后下尿路症状(lower urinary tract symptoms,LUTS)再评估的临床价值。方法:回顾性分析了2015年1月至2016年12月期间234例接受TUVP的良性前列腺增生(benign prostatic hyperplasia,BPH)患者的国际前列腺症状评分(international prostatic symptom score,IPSS)等临床资料。按照IPSS-V/S比值将患者分为A组(IPSS-V/S≤1,80例)和B组(IPSS-V/S>1,154例)。术后6个月再次评估IPSS,储尿期症状评分(international prostatic symptom score-storage,IPSS-S),排尿期症状评分(international prostatic symptom score-voiding,IPSS-V)和生活质量评分(quality of life,QOL)。结果:234例患者术后6个月IPSS和QOL较术前明显降低,差异有统计学意义(t=33.0,P=0.000;t=34.3,P=0.000)。术后6个月B组患者IPSS改善程度明显优于A组[(12.36±3.67)分vs.(8.20±3.21)分](t=8.96,P=0.000)。其中A组术后6个月IPSS-S明显高于B组[(9.61±2.88)分vs.(5.55±2.63)分](t=10.8,P=0.000);而2组患者术后6个月时IPSS-V对比无统计学差异(t=1.56,P=0.120)。虽然A组术后6个月的QOL明显改善[(3.59±0.91)分vs.(5.19±0.55)分](t=14.8,P=0.000),但是基本满意及以上者仅占13.75%,明显低于B组的70.78%。A组术后6个月IPSS-S各症状评分均有一定改善,改善程度从高到低依次为尿急评分、尿频评分和夜尿评分,其中夜尿评分改善率最低,仅为36.3%(29/80),是A组患者IPSS及QOL改善较小的重要原因。结论:相比IPSS,IPSS-V/S更能准确反映TUVP术后疗效,LUTS排尿期症状改善明显优于储尿期症状。对于以夜尿症为主的BPH/LUTS患者,TUVP对患者QOL改善有限,需要引起临床医师重视。

不同严重程度前列腺增生尿道周围前列腺组织SWE及其与IPSS相关性分析

目的探究不同严重程度前列腺增生尿道周围前列腺组织SWE及其与IPSS相关性分析。方法选取2016年9月至2017年9月恩施市中心医院诊治的良性前列腺增生的76例患者作为研究对象。同时,选取20例健康志愿者为正常组,对所有患者进行IPSS评分,根据评分将患者分为轻度、中度、严重3组,然后对患者进行直肠超声检查(TRUS),通过计算得出患者前列腺重量,根据重量将患者分成A组、B组、C组、D组,最后进行实时剪切波弹性成像(SWE),比较各组尿道周围前列腺组织弹性模量差异,评价每组间弹性模量与前列腺重量、IPSS评分严重程度、患者年龄的相关性。结果经过对不同重量的前列腺尿道周围组织弹性模量对比分析,四组患者上部A区、上部B区、中部A区、中部B区、下部A区组间差异均无统计学意义(均P>0.05),下部B区组织弹性模量随着患者前列腺重量的增加而增加,差异具有统计学意义(P<0.05);经过对不同严重程度的前列腺尿道周围组织弹性模量对比分析,不同部位的尿道周围组织弹性模量随着前列腺增生的严重程度的升高而增加,差异具有统计学意义(P<0.05);经过对不同年龄的前列腺尿道周围组织弹性模量对比分析,尿道周围组织弹性模量随着前列腺增生患者的年龄的增加而增加,差异具有统计学意义(P<0.05);经过相关性分析,前列腺的重量与IPSS呈正相关(r=0.354,P 0.05);前列腺增生尿道周围组织弹性模量与IPSS呈正相关,上部A区(r=0.740,P<0.01)、上部B区(r=0.863,P<0.01)、中部A区(r=0.792,P<0.01)、中部B区(r=0.835,P<0.01)、下部A区(r=0.761,P<0.01)、下部B区(r=0.862,P<0.01);前列腺增生尿道周围组织弹性模量与患者年龄呈正相关(r=0.613,P<0.05)。结论前列腺尿道周围组织弹性模量与前列腺增生严重程度、患者年龄呈正相关,因此SWE可以用做无创评估患者前列腺增生严重程度的方法。

益肾活血通关汤对前列腺增生患者尿流动力学及IPSS评分的影响

目的:探究益肾活血通关汤在前列腺增生(BPH)患者中的应用效果。方法:研究对象为萍乡矿业集体有限公司总医院2020年1月至2020年12月期间诊治BPH患者70例,采用随机数字表法将其分为对照组和观察组,对照组35例(非那雄胺片单一药物治疗),观察组35例(非那雄胺片+益肾活血通关汤联合治疗),比较不同治疗方式对患者尿流动力学及IPSS评分的影响。结果:对照组治疗总有效率(77.14%)低于观察组(94.29%),差异有统计学意义(P=0.040);治疗前,两组尿流动力学指标比较,差异无统计学意义(P>0.05);治疗后,观察组残余尿量(PVR)、前列腺体积低于对照组,最大尿流量(Qmax)、膀胱最大储尿量(VMCC)高于对照组,差异有统计学意义(P<0.05);治疗前,两组IPSS评分比较,差异无统计学意义(P>0.05);治疗后,两组前列腺症状均有所改善,观察组改善效果优于对照组,差异有统计学意义(P<0.05);观察组不良反应发生率(8.57%)低于对照组(28.57%),差异有统计学意义(P=0.031)。结论:对BPH患者采用益肾活血通关汤医治,治疗效果显著。

前列腺体积与IPSS的关系

目的:了解前列腺体积、腺体突入膀胱的距离与IPSS的关系。方法:对181例男子作经腹B超测量前列腺的体积、腺体突入膀胱的距离及回顾性IPSS问卷调查。结果:随前列腺体积及腺体突入膀胱距离增大,IPSS评分增加(P<0.05及P<0.01)。结论:IPSS评分结合前列腺体积及腺体突入膀胱的距离对评价前列腺增生患者症状的严重程度、选择治疗方法和评价治疗效果有重要的临床价值。

糖尿病对中老年男性下尿路症状的影响

目的探讨糖尿病对中老年男性下尿路症状的影响。方法选取2021年12月至2022年3月新乡医学院第一附属医院因下尿路症状入院治疗的252例中老年男性患者为研究对象,根据是否患有糖尿病将其分为糖尿病组(83例)和非糖尿病组(169例)。对两组进行国际前列腺症状评分(IPSS)及健康相关生活质量(HRQOL)问卷调查、自由尿流率检查及残余尿量(RUV)测量,比较两组各量表评分差异,比较糖尿病组不同病程(≥5年,55例;<5年,28例)及空腹血糖(FPG)(>10.0 mmol/L,38例;≤10.0 mmol/L,45例)患者的各量表评分差异。结果糖尿病组最大尿流率、平均尿流率均低于非糖尿病组,IPSS、HRQL问卷评分、储尿期评分高于非糖尿病组,差异有统计学意义(P<0.05)。病程≥5年的糖尿病患者储尿期评分、HRQL问卷评分均低于病程<5年的患者,差异有统计学意义(P<0.05)。FPG>10.0 mmol/L的糖尿病患者平均尿流率高于FPG≤10.0 mmol/L的患者,差异有统计学意义(P<0.05)。结论中老年男性糖尿病患者的下尿路症状较重,其生活质量也有所降低。

良性前列腺增生患者残余尿量过多的影响因素及诊断模型

目的探讨良性前列腺增生(BPH)患者残余尿量过多的影响因素并构建诊断模型。方法根据残余尿量将60例BPH患者分为残余尿量<20 mL组28例与残余尿量≥20 mL组32例。比较两组患者的年龄、BPH病程、前列腺体积、最大尿流率、排尿次数、国际前列腺症状评分(排尿不尽感得分、2 h内排尿得分、排尿间断性得分、排尿不能等待得分、尿线变细得分、排尿用力得分、夜尿次数得分)、小腹胀满得分、尿急程度得分。采用多因素Logistic回归模型分析BPH患者残余尿量过多的影响因素。基于获得的影响因素构建诊断模型,采用混淆矩阵计算模型计算总体诊断正确率,采用Hosmer-Lemeshow检验评价拟合度。结果两组患者的前列腺体积、最大尿流率、排尿次数、排尿不尽感得分、2 h内排尿得分、排尿间断性得分、排尿不能等待得分、尿线变细得分、夜尿次数得分、小腹胀满得分、尿急程度得分比较,差异均具有统计学意义(均P<0.05)。多因素Logistic回归分析结果显示,最大尿流率、排尿间断性得分、小腹胀满得分为BPH患者残余尿量过多的影响因素(均P<0.05)。构建诊断模型:Logit(P)=2.617-2.352×最大尿流率-1.997×排尿间断性得分-1.693×小腹胀满得分。诊断模型的总体诊断正确率为83.3%,拟合度良好(Hosmer-Lemeshow检验显示P>0.05)。结论最大尿流率、排尿间断性得分、小腹胀满得分均为BPH患者残余尿量过多的影响因素。通过上述3个指标构建的BPH患者残余尿量过多的诊断模型的总体诊断正确率较高,拟合度良好。

前列舒通胶囊联合盐酸坦索罗辛缓释胶囊治疗前列腺增生术后临床研究

目的:观察前列舒通胶囊联合盐酸坦索罗辛缓释胶囊治疗前列腺增生(BPH)经尿道前列腺等离子电切术(TURP)后患者的临床效果。方法:选择98例BPH TURP术后湿热瘀阻证患者,按随机数字表法分为治疗组50例与对照组48例,2组均给予TURP治疗,术后对照组予盐酸坦索罗辛缓释胶囊治疗,治疗组予前列舒通胶囊与盐酸坦索罗辛缓释胶囊治疗,2组均治疗1个月。于治疗前、治疗1个月后评估国际前列腺症状评分(IPSS),检测血清睾酮(T)、雌二醇(E_(2))水平,采用B型超声波检查前列腺大小,计算前列腺体积(PV),测定膀胱残余尿量(RV)及最大尿流量(Q_(max))。比较2组临床疗效。结果:治疗后,治疗组临床疗效总有效率高于对照组(P<0.05)。2组IPSS均较治疗前下降(P<0.05),治疗组IPSS低于对照组(P<0.05)。2组血清T水平与治疗前比较,差异均无统计学意义(P>0.05);2组血清E_(2)水平均较治疗前上升(P<0.05)。治疗组E_(2)水平高于对照组(P<0.05)。2组PV、RV值均较治疗前下降,Q_(max)值均较治疗前上升,差异均有统计学意义(P<0.05)。治疗组PV、RV值均低于对照组,Q_(max)值高于对照组,差异均有统计学意义(P<0.05)。结论:前列舒通胶囊联合盐酸坦索罗辛缓释胶囊治疗BPH TURP术后湿热瘀阻证患者可提高临床疗效,调节性激素水平,有效改善临床症状。

基于MRI多参数评价激光剜除治疗中重度良性前列腺增生的临床疗效

目的基于MRI多参数评价激光剜除治疗中重度良性前列腺增生(BPH)的临床疗效。方法选取中重度BPH患者144例,均接受超声引导下经尿道激光剜除术,于术前、术后1个月和6个月采用1.5T对比增强MRI序列(包括T1WI、T2WI和DWI)评价前列腺体积、激光剜除面积、针迹可视化、尿道周围水肿、腔隙和尿道形态保存,比较血清前列腺特异性抗原(PSA)、尿动力学最大尿流率(Qmax)和排泄后残留尿量(PVR)、国际前列腺症状评分(IPSS)和国际生活质量(I-QoL)评分,使用Clavien Dindo量表评估不良事件。结果手术前后患者血清PSA水平无明显变化(F=0.56,P>0.05)。术后1个月和6个月患者Qmax和I-QoL评分较术前明显升高,PVR和IPSS评分较术前明显下降(LSD-t分别=5.63、3.65;33.32、19.65;22.30、11.21;42.32、89.63,P均<0.05)。术后1个月和6个月MRI显示前列腺体积比术前明显缩小,术后6个月剜除面积比术后1个月明显缩小,针迹可视化率、水肿率和腔隙率明显下降(t=102.32,χ^(2)分别=148.56、184.11、120.60,P均<0.05),尿道形态保存率与术前相比无明显变化(χ^(2)=0.68,P>0.05)。随访6个月无严重不良事件发生。结论对比增强MRI多个序列能够定量和定性评价激光剜除治疗中重度BPH的临床疗效,有较好的应用价值。