Aim： To compare the use of the suprapubic puncture method versus the transurethral method in pressure-flow studies in patients with benign prostatic hyperplasia. Methods： Twenty-three men with benign prostatic hyper...Aim： To compare the use of the suprapubic puncture method versus the transurethral method in pressure-flow studies in patients with benign prostatic hyperplasia. Methods： Twenty-three men with benign prostatic hyperplasia underwent both suprapubic and transurethral pressure-flow studies during a single session. Standard pressure-flow variables were recorded in all patients with both methods, enabling calculation of obstruction using commonly used grading systems, such as the urethral resistance algorithm, the Abrams-Griffith （AG） number and the Schaefer linear nomogram. Results： There were statistically significant differences between the methods in the mean values of maximum flow rate （P 〈 0.05）, detrusor pressure at the maximum flow （P 〈 0.01）, urethral resistance algorithm （P 〈 0.01）, AG number （P 〈 0.01） and maximum cystic capacity （P 〈 0.01）. Of the men in the study, 10 （43.5%） remained in the same Schaefer class with both methods and 18 （78.3%） in the same AG number area. Using the transurethral method, 12 （52.2%） men increased their Schaefer class by one and 1 （4.3%） by two. There were also differences between the suprapubic and transurethral methods using the AG number： 4 （17.4%） men moved from a classification of equivocal to obstructed and 1 （4.3%） from unobstructed to equivocal. Conclusion： The differences between the techniques for measuring intravesical pressure alter the grading of obstruction determined by several of the commonly used classifications. An 8 F transurethral catheter significantly increases the likelihood of a diagnosis of bladder outlet obstruction when compared with the suprapubic method.展开更多
目的:探讨尿流动力学检查参数最大尿流率(Qura of maximum,Qmax)、残余尿量(Postvoid residual volume,PVR)、膀胱最大储尿量(Volume cystometric capacity,VMCC)与拟行膀胱造瘘术及经尿道前列腺电切术(Transurethral resection of the ...目的:探讨尿流动力学检查参数最大尿流率(Qura of maximum,Qmax)、残余尿量(Postvoid residual volume,PVR)、膀胱最大储尿量(Volume cystometric capacity,VMCC)与拟行膀胱造瘘术及经尿道前列腺电切术(Transurethral resection of the prostate,TURP)的前列腺增生患者发生膀胱出口梗阻(Bladder outlet obstruction,BOO)严重程度的相关性。方法:选取2019年8月~2021年6月于我院就诊的158例拟行膀胱造瘘术及TURP术的前列腺增生患者作为研究对象,所有患者均接受经膀胱造瘘术及尿流动力学检查,根据是否发生BOO分为BOO发生组(n=124)和BOO未发生组(n=34)。比较BOO发生组、BOO未发生组,以及BOO发生组中不同梗阻程度患者尿流动力学检查参数(Qmax、PVR、VMCC),分析Qmax、PVR、VMCC与前列腺增生患者发生BOO梗阻严重程度的相关性,并比较BOO不同预后患者的Qmax、PVR、VMCC。结果:BOO发生组Qmax、VMCC水平低于BOO未发生组,PVR水平高于BOO未发生组(P<0.05);BOO发生组不同严重程度患者的Qmax、VMCC水平比较:轻度梗阻>中度梗阻>重度梗阻(P<0.05);PVR水平比较:轻度梗阻<中度梗阻<重度梗阻(P<0.05)。Qmax、VMCC水平与是否发生BOO,及梗阻严重程度呈负相关(P<0.05),PVR水平与是否发生BOO,及梗阻严重程度呈正相关(P<0.05)。结论:尿流动力学检查参数Qmax、PVR、VMCC与行膀胱造瘘术的前列腺增生患者是否发生BOO及梗阻严重程度密切相关,临床可通过检测患者Qmax、PVR、VMCC水平,辅助临床判断BOO严重程度,为临床制定相应的治疗方案提供依据。展开更多
Background Detrusor overactivity （DO） is a known cause of lower urinary tract symptoms and occurs in 50%-75% of benign prostate hyperplasia （BPH） patients. We sought to investigate the clinical and urodynamic fact...Background Detrusor overactivity （DO） is a known cause of lower urinary tract symptoms and occurs in 50%-75% of benign prostate hyperplasia （BPH） patients. We sought to investigate the clinical and urodynamic factors that are associated with the presence of DO in Chinese BPH patients.展开更多
We aimed to develop and validate a clinical nomogram predicting bladder outlet obstruction(BOO)solely using routine clinical parameters in men with refractory nonneurogenic lower urinary tract symptoms(LUTS).A total o...We aimed to develop and validate a clinical nomogram predicting bladder outlet obstruction(BOO)solely using routine clinical parameters in men with refractory nonneurogenic lower urinary tract symptoms(LUTS).A total of 750 eligible patient ≥50 years of age who had previously not responded(International Prostate Symptom Score[IPSS]improvement<4 points)to at least three different kinds of LUTS medications(including a-blocker)for the last 6 months were evaluated as subcohorts for nomogram development(n=570)and for split-sample validation(n=180).BOO was defined as Abrams-Griffiths number^40,or 20-39.9 with a slope of linear passive urethral resistance ratio>2 cmH20 ml^-1 s^-1.A stepwise multivariable logistic regression analysis was conducted to determine the predictors of BOO,and^-coefficients of the final model were selected to create a clinical nomogram.The final multivariable logistic regression model showed that age,IPSS,maximum urinary flow rate,postvoid residual volume,total prostate volume,and transitional zone index were significant for predicting BOO;these candidates were used to develop the final nomogram.The discrimination performance of the nomogram was 88.3%(95%Cl:82.7%-93.0%,P<0.001),and the nomogram was reasonably we 11-fitted to the ideal line of the calibration plot.Independe nt split-sample validation revealed 80.9%(95%Cl:75.5%-84.4%,P<0.001)accuracy.The proposed BOO nomogram based solely on routine clinical parameters was accurate and validated properly.This nomogram may be useful in determining further treatment,primarily focused on prostatic surgery for BOO,without impeding the detection of possible BOO in men with LUTS that is refractory to empirical medications.展开更多
文摘Aim： To compare the use of the suprapubic puncture method versus the transurethral method in pressure-flow studies in patients with benign prostatic hyperplasia. Methods： Twenty-three men with benign prostatic hyperplasia underwent both suprapubic and transurethral pressure-flow studies during a single session. Standard pressure-flow variables were recorded in all patients with both methods, enabling calculation of obstruction using commonly used grading systems, such as the urethral resistance algorithm, the Abrams-Griffith （AG） number and the Schaefer linear nomogram. Results： There were statistically significant differences between the methods in the mean values of maximum flow rate （P 〈 0.05）, detrusor pressure at the maximum flow （P 〈 0.01）, urethral resistance algorithm （P 〈 0.01）, AG number （P 〈 0.01） and maximum cystic capacity （P 〈 0.01）. Of the men in the study, 10 （43.5%） remained in the same Schaefer class with both methods and 18 （78.3%） in the same AG number area. Using the transurethral method, 12 （52.2%） men increased their Schaefer class by one and 1 （4.3%） by two. There were also differences between the suprapubic and transurethral methods using the AG number： 4 （17.4%） men moved from a classification of equivocal to obstructed and 1 （4.3%） from unobstructed to equivocal. Conclusion： The differences between the techniques for measuring intravesical pressure alter the grading of obstruction determined by several of the commonly used classifications. An 8 F transurethral catheter significantly increases the likelihood of a diagnosis of bladder outlet obstruction when compared with the suprapubic method.
文摘目的:探讨尿流动力学检查参数最大尿流率(Qura of maximum,Qmax)、残余尿量(Postvoid residual volume,PVR)、膀胱最大储尿量(Volume cystometric capacity,VMCC)与拟行膀胱造瘘术及经尿道前列腺电切术(Transurethral resection of the prostate,TURP)的前列腺增生患者发生膀胱出口梗阻(Bladder outlet obstruction,BOO)严重程度的相关性。方法:选取2019年8月~2021年6月于我院就诊的158例拟行膀胱造瘘术及TURP术的前列腺增生患者作为研究对象,所有患者均接受经膀胱造瘘术及尿流动力学检查,根据是否发生BOO分为BOO发生组(n=124)和BOO未发生组(n=34)。比较BOO发生组、BOO未发生组,以及BOO发生组中不同梗阻程度患者尿流动力学检查参数(Qmax、PVR、VMCC),分析Qmax、PVR、VMCC与前列腺增生患者发生BOO梗阻严重程度的相关性,并比较BOO不同预后患者的Qmax、PVR、VMCC。结果:BOO发生组Qmax、VMCC水平低于BOO未发生组,PVR水平高于BOO未发生组(P<0.05);BOO发生组不同严重程度患者的Qmax、VMCC水平比较:轻度梗阻>中度梗阻>重度梗阻(P<0.05);PVR水平比较:轻度梗阻<中度梗阻<重度梗阻(P<0.05)。Qmax、VMCC水平与是否发生BOO,及梗阻严重程度呈负相关(P<0.05),PVR水平与是否发生BOO,及梗阻严重程度呈正相关(P<0.05)。结论:尿流动力学检查参数Qmax、PVR、VMCC与行膀胱造瘘术的前列腺增生患者是否发生BOO及梗阻严重程度密切相关,临床可通过检测患者Qmax、PVR、VMCC水平,辅助临床判断BOO严重程度,为临床制定相应的治疗方案提供依据。
文摘Background Detrusor overactivity （DO） is a known cause of lower urinary tract symptoms and occurs in 50%-75% of benign prostate hyperplasia （BPH） patients. We sought to investigate the clinical and urodynamic factors that are associated with the presence of DO in Chinese BPH patients.
文摘We aimed to develop and validate a clinical nomogram predicting bladder outlet obstruction(BOO)solely using routine clinical parameters in men with refractory nonneurogenic lower urinary tract symptoms(LUTS).A total of 750 eligible patient ≥50 years of age who had previously not responded(International Prostate Symptom Score[IPSS]improvement<4 points)to at least three different kinds of LUTS medications(including a-blocker)for the last 6 months were evaluated as subcohorts for nomogram development(n=570)and for split-sample validation(n=180).BOO was defined as Abrams-Griffiths number^40,or 20-39.9 with a slope of linear passive urethral resistance ratio>2 cmH20 ml^-1 s^-1.A stepwise multivariable logistic regression analysis was conducted to determine the predictors of BOO,and^-coefficients of the final model were selected to create a clinical nomogram.The final multivariable logistic regression model showed that age,IPSS,maximum urinary flow rate,postvoid residual volume,total prostate volume,and transitional zone index were significant for predicting BOO;these candidates were used to develop the final nomogram.The discrimination performance of the nomogram was 88.3%(95%Cl:82.7%-93.0%,P<0.001),and the nomogram was reasonably we 11-fitted to the ideal line of the calibration plot.Independe nt split-sample validation revealed 80.9%(95%Cl:75.5%-84.4%,P<0.001)accuracy.The proposed BOO nomogram based solely on routine clinical parameters was accurate and validated properly.This nomogram may be useful in determining further treatment,primarily focused on prostatic surgery for BOO,without impeding the detection of possible BOO in men with LUTS that is refractory to empirical medications.
