Uroflowmetry in a Large Population of Brazilian Men Submitted to a health check up program and its correlation with ipss and prostate size

Abstract

Purpose: The aim of this study was to assess the uroflowmetry data in a large population of asymptomatic Brazilian men submitted to a health check up program and their correlation to IPSS and prostate size. Materials and Methods: Asymptomatic men underwent a health check-up program between January and December 2012. The inclusion criteria were men between 40 and 70 years, IPSS ≤ 7, without bladder, prostate, urethral surgery, neurological diseases, urinary tract infection, PSA < 4.0 ng/dL and urinary volume higher than 150 mL. Urological assessment consisted of clinical history, IPSS, digital rectal examination (DRE), prostate specific antigen (PSA), urinalysis, ultrasonography and uroflowmetry. Results: A total of 1041 asymptomatic men were included in this study. The average age was 49 years and average maximum flow rate was 17.4 mL/s. In spite of IPSS and prostate size increase with aging, they had a weak correlation with Q max cutoffs (10 mL/s and 15 mL/s). A total of 85 men (8.3%) had more than 60 years, and even in this group, Q max was higher than 15 mL/s. Out of 1041 men, 117 had IPSS less than 8 and Q max less than 10 mL/s. Conclusions: In asymptomatic men there is a weak correlation between IPSS, prostate size and uroflowmetric data. The establishment of different normal cutoffs seems to be complicated and uroflowmetry data should be interpreted with caution in order to avoid misdiagnosis.

Correlation of Uroflowmetry with Prostate Volume and International Prostatic Symptom Score (IPSS)

“…In our study we found negative relationship of Qmax with IPSS (Table 3) therefore substantial the size of gland lower was the Qmax and greater the IPSS lower was peak flow rate. Our results were in consensus with Zamboan et al they also observed negative relationship between Qmax with prostate volume and IPSS 15 Singla et al also found negative correlation of Qmax with prostate volume as prostate enlarges Qmax is increasing rather instead of decreasing values and going towards obstruction however Qmax showed no correlation with prostate volume in our study. According to recent study published in 2022 they could not find any correlation between prostate volume and Qmax 16 .…”

“…The total score ranges from 0 to 35 (asymptomatic to symptomatic). The Symptom index is categorized as mild ( 7), moderate (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19) and severe ( 20)". Each question is further divided into 5 question 0.…”

Uroflowmetry and Post-Void Urine Volume in the Initial Evaluation of Suspected Obstructive Prostatic Enlargement

“…As expected, these results differ from normal values because of the patients included. An abnormal uroflowmetry suggests abnormal micturition and the objective is early detection of bladder outlet obstruction and offer prompt treatment to avoid bladder dysfunction or complications as acute urine retention or kidney failure [6]. Outcomes in this study were: 26.3% non-obstructive patients and 73.7% obstructive patients.…”

“…Uroflowmetry must be used with caution and always with other diagnostic tools like International Prostatic Symptoms Score (IPSS) and transabdominal prostatic ultrasound with post-void urine volume [6]. There is great variability in uroflowmetry parameters, even in healthy patients, because of that it is suggested to use high normal values that diminish specificity but augment sensibility of patients with outlet bladder obstruction.…”

Correlação de ferramentas não invasivas na avaliação da obstrução infra vesical em homens com sintomas do trato urinário inferior Correlation of tools for objective evaluation of infravesical obstruction of men with lower urinary tract symptoms

“…Ainda não há um parâmetro, na prática clínica diária, confiável e especifico para definir a severidade da obstrução infravesical causada pela HBP, e indicar, se ela já está instalada, porém, assintomática. Ela pode ser objetivamente documentada, mas não quantificado o grau e a severidade da obstrução, uma vez que a obstrução sem sintomas pode ocorrer (34,35) .…”