Can we identify men who will have complications from benign prostatic obstruction (BPO)?: ICI‐RS 2011

Abstract

In contrast to the widespread belief of urologist, there is only rudimentary data available showing no convincing association between urinary tract complications and BPO. The ICI-RS proposes that prospective trials are conducted to demonstrate the association between complications and BPO by using cystometry, pressure-flow (P/F) studies, and other commonly used BPO parameters in men with complications and comparing those with a cohort of age-matched men without complications. Non-invasive proxy parameters of BPO, for example, ultrasonic measurement of detrusor wall thickness, can be used instead of P/F studies especially in longitudinal trials.

EAU Guidelines on the Assessment of Non-neurogenic Male Lower Urinary Tract Symptoms including Benign Prostatic Obstruction

“…Hydronephrosis, renal insufficiency, and urinary retention appear with greater prevalence in patients with symptoms or signs of BPO [57]. Even though BPO may be partly responsible for these complications, there is no conclusive evidence that BPO is the primary cause [57].…”

Hyperglycemia and Insulin Resistance and the Risk of BPH/LUTS: an Update of Recent Literature

“…This increased nerve activity may contribute to increased prostate smooth muscle tone and subsequent bladder outlet obstruction. Increased outlet resistance can lead to obstructive symptoms as well as potential future irritative symptoms [12]. In addition, increased insulin concentrations secondary to diabetes may have a trophic affect that leads to enlarged prostate size [13].…”

Maximum Urine Flow Rate of Less than 15ml/Sec Increasing Risk of Urine Retention and Prostate Surgery among Patients with Alpha-1 Blockers: A 10-Year Follow Up Study

“…A key goal of treatment for BPH with LUTS is to prevent urinary retention and the need for prostate surgery [ 17 ]. Urinary retention can have a significant impact on patient quality of life, and the effectiveness of drug therapy following prostate surgery to treat urinary tract syndrome is less than ideal [ 18 ]. These two results are often used as indicators for the clinical evaluation of BPH with LUTS.…”

“…Third, this study found that for patients with a maximum urinary flow rate of 15ml/sec, patient age and residence in southern and eastern Taiwan are all risk factors for urinary retention and prostate surgery. Patient age is already a widely recognized risk factor [ 18 ]. However, patients residing in southern and eastern Taiwan are at greater risk for urinary retention and prostate surgery than those living in the north and west.…”