Correlation of tools for objective evaluation of infravesical obstruction of men with lower urinary tract symptoms

Mazzariol, Orestes; Reis, Leonardo Oliveira; Palma, Paulo

doi:10.1590/s1677-5538.ibju.2018.0706

Cited by 4 publications

(4 citation statements)

References 31 publications

(31 reference statements)

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“…It is also well known that a simple uroflowmetry can suggest but not diagnose the cause of a possible voiding dysfunction and that BOO can only be diagnosed by urodynamics. 20 Moreover, previous studies about minimal invasive thermal therapies for BPH such as TUMT or TUNA proved that only an adequate urodynamic analysis, which distinguishes different grade and types of BOO i.e. compressive or constrictive, can properly predict the clinical success.…”

Section: Discussionmentioning

confidence: 99%

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Transurethral water vapor ablation of the prostate with the Rezūm system: Urodynamic findings

Martinelli

Cindolo²,

Grossi

et al. 2022

Neurourology and Urodynamics

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Aims The efficacy of the transurethral convective interstitial radiofrequency water vapor thermal ablation of the prostate with the Rezūm system for the treatment of male lower urinary tract symptom due to benign prostatic hyperplasia is well proven. The improvement of urodynamic parameters obtained from a simple uroflowmetry cannot measure the effect of water vapor injection on the bladder outlet obstruction. Methods This monocentric retrospective pilot study analyzes the data of pressure‐flow studies performed before and after 17 Rezūm procedures to answer the question whether thus obtained ablation of prostate tissue has a disobstructive effect on the bladder outlet. Results All the functional outcomes were consistently improved after the procedure, with a median flowrate increase of 5.1 ml/s (p = 0.0022) and a median postvoid residual urine (PVR) reduction of 100 ml (p = 0.0042). The prostate volume was reduced by 40% (p < 0.0001) and the median Bladder Outlet Obstruction Index (BOOI) reduction was 53.8 (p < 0.0001). Conclusions These data show that the possibility to significantly reduce the obstruction grade with even a single Rezūm procedure is concrete and seems to be independent from the degree of the obstruction grade.

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Section: Discussionmentioning

confidence: 99%

“…It is also well known that a simple uroflowmetry can suggest but not diagnose the cause of a possible voiding dysfunction and that BOO can only be diagnosed by urodynamics 20 …”

Section: Discussionmentioning

confidence: 99%

Transurethral water vapor ablation of the prostate with the Rezūm system: Urodynamic findings

Martinelli

Cindolo²,

Grossi

et al. 2022

Neurourology and Urodynamics

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“…The American Urological Association recommends the former to evaluate the severity of LUTS and is the best method for evaluating the severity of symptoms in patients with BPH (24). The QoL score is mainly used to evaluate the degree of LUTS distress and tolerance in patients with BPH (25). Qmax can be used as an indicator to assess disease progression and the preoperative and postoperative surgical outcomes in patients with BPH.…”

Section: Comparison Of Qol Data Between the Two Groups Before And Aft...mentioning

confidence: 99%

Clinical analysis of transurethral holmium laser enucleation in the treatment of benign prostatic hyperplasia with prostatic inflammation: A prospective research study

Zhou

Mao²,

Li³

et al. 2023

Front. Surg.

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ObjectiveTo investigate the clinical efficacy of holmium laser enucleation of the prostate (HoLEP) in the treatment of benign prostatic hyperplasia (BPH) with prostatic inflammation (PI).MethodsWe prospectively collected and followed up data on patients with BPH who underwent HoLEP at the Affiliated Hospital of Weifang Medical University between July 2021 and July 2022. According to the postoperative pathological results, the patients were divided into two groups: BPH without PI group (BPH group) and BPH with PI group. Statistical analysis was performed on clinical data, including age and body mass index (BMI), prostate volume (PV), postoperative residual urine volume (PVR), preoperative serum total prostate-specific antigen (tPSA), serum-free prostate-specific antigen (fPSA), preoperative and postoperative maximum urinary flow rate (Qmax), International Prostate Symptom Score (IPSS) before and 3 months after surgery, quality of life index (QoL) before and 3 months after surgery, and postoperative complications.ResultsA total of 41 patients were included in this study, including 16 in the BPH group and 25 in the BPH with PI group. There were no significant differences in preoperative age, BMI, PV, PVR, tPSA, fPSA, and f/tPSA between the BPH and BPH with PI groups (P > 0.05). The preoperative mean Qmax of the BPH and BPH with PI groups were 9.44 ± 2.449 and 7.52 ± 2.946 [mean ± standard deviation (SD)] ml/s, mean IPSS were 17.75 ± 5.335 and 24.24 ± 5.861 (mean ± SD), and mean QoL were 4.13 ± 0.806 and 4.48 ± 0.8 (mean ± SD), respectively. The postoperative mean Qmax of the BPH and BPH with PI groups were 20.38 ± 4.787 and 14.32 ± 3.827 (mean ± SD) ml/s, mean IPSS were 2.69 ± 1.25 and 5.84 ± 3.579 (mean ± SD), and mean QoL were 0.13 ± 0.342 and 0.92 ± 0.759 (mean ± SD), respectively. In both groups, Qmax significantly increased (P < 0.05) and IPSS and QoL significantly decreased after HoLEP (P < 0.05). Before and after surgery, the Qmax in the BPH with PI group was lower than that in the BPH group, and the IPSS and QoL levels in the BPH with PI group were higher than those in the BPH group (P < 0.05). Compared with the BPH group, the increase in Qmax in the BPH with PI group was smaller and the decrease in IPSS was larger (P < 0.05), but the variation in QoL was not statistically significant (P > 0.05).ConclusionImprovements in Qmax, IPSS, and QoL in BPH patients with PI after HoLEP surgery were lower than those in BPH patients alone. PI may be a predictor of a worse response to surgical treatment. However, more multicenter randomized controlled trials with larger samples and long-term follow-up are needed to verify this.

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“…Симптоми наповнення зазвичай також описують як «іритативні симптоми» і часто поєднують із синдромом гіперактивного сечового міхура (ГАСМ), тоді як симптоми спорожнення асоціюються із «симптомами обструкції» або інфравезикальною обструкцією (ІВО) [10][11][12].…”

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Diagnosis and Treatment of Overactive Bladder in Young Men

Oleh

Hennadii

2022

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The objective: to analyze the diagnostic capabilities and various methods of treatment of overactive bladder in young patients with lower urinary tract symptoms (LUTS). Materials and methods. The study involved 40 men who were divided into two groups. The main group included 24 patients with urodynamic diagnosis of overactive bladder (OAB) who were treated for LUTS. The age of patients ranged from 21-37 years old (mean age – 28.5±2.4 years). The control group included 16 men 21-48 years old (mean age – 36.32±2.34 years) without LUTS. The patients had complex urodynamic testing (UDT) for the diagnosis, the treatment management, and to determine the degree of functional disorders of the urination. The clinical task of treatment of OAB was to control the involuntary contractions of the bladder to normalize the quality of patient’s life. In 14 (58.3 %) patients of the main group solifenacin at a dose of 10 mg was used, in 10 (41.7 %) men – mirabegron at a dose of 50 mg. Results. The results of the first line therapy were studied in 1 month and then a decision was made to continue treatment or to change the medical approach. During the evaluation of the effectiveness of therapy, it was determined that the first line therapy was effective in 11 (45.8 %) patients, and in 13 (54.2 %) patients there was effect. In the absence of the results of medication treatment of OAB in 1 month in 8 out of 13 patients the treatment with the second line drug was prescribed – intradetruce injections of Botox. During the analysis of complex UDT after 12-18 months of the first injection of Botox, positive dynamics of therapy was estabslihed. Conclusions. Complex urodynamic testing is a reliable method of diagnosis and control of therapy. It is performed in the presence of overactive bladder (OAB). It is proved that if initially first-line drug therapy in young men is effective, it remained efficacy in longer period. If the first line therapy by botulotoxin injection in young men with OAB is not effective this led to some reduction in the tone of the detrusor. However, clinically this type of therapy has contributed to a significant improvement in the patient’s quality of life and the normalization of urodynamic.

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Correlation of tools for objective evaluation of infravesical obstruction of men with lower urinary tract symptoms

Cited by 4 publications

References 31 publications

Transurethral water vapor ablation of the prostate with the Rezūm system: Urodynamic findings

Transurethral water vapor ablation of the prostate with the Rezūm system: Urodynamic findings

Clinical analysis of transurethral holmium laser enucleation in the treatment of benign prostatic hyperplasia with prostatic inflammation: A prospective research study

Diagnosis and Treatment of Overactive Bladder in Young Men

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