Correlation of Prostatic Urethral Angle with the Severity of Urinary Symptom and Peak Flow Rate in Men with Small Prostate Volume

Kang, Dong Hyuk; Lee, Joo Yong; Hah, Yoon Soo; Chung, Doo Yong; Lee, Dae Hun

doi:10.1371/journal.pone.0104395

Cited by 20 publications

(29 citation statements)

References 22 publications

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“…Meanwhile, a higher bladder neck on cystourethroscopy is generally thought to be a causal factor of BOO and LUTS, and corresponds with increased PUA on TRUS. PUA is significantly associated with Q max and urinary symptom score in patients with LUTS/BPH, and its informative value seems to be more pronounced in men with LUTS and a small TPV [7,8]. Ku et al [9] maintained that PUA is a non-invasive method to assess BOO, although PUA was not associated with urinary symptoms and Q max in their patients.…”

Section: Discussionmentioning

confidence: 99%

“…However, there is conflicting published evidence about whether the TZI is associated with urinary symptoms . During the last decade, there have been several reports on IPP and PUA . Chia et al.…”

Section: Discussionmentioning

confidence: 99%

“…Accordingly, previous studies have indicated that the correlation between total prostate volume (TPV) and LUTS severity is relatively modest . Therefore, researchers have searched for other prostatic anatomical factors, such as transitional zone volume (TZV), transitional zone index (TZI), presumed circle area ratio (PCAR), intravesical prostatic protrusion (IPP), and prostatic urethral angulation (PUA) , which are more significantly associated with urinary symptom scores, maximum urinary flow rate (Q max ), and urodynamically confirmed obstruction than TPV.…”

Section: Introductionmentioning

confidence: 99%

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Clinical significance of peripheral zone thickness in men with lower urinary tract symptoms/benign prostatic hyperplasia

et al. 2015

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ObjectiveTo evaluate the clinical impact of prostate peripheral zone thickness (PZT), based on presumed circle area ratio (PCAR) theory, on urinary symptoms in men with lower urinary tract symptoms/benign prostatic hyperplasia (LUTS/BPH) as a novel prostate parameter. Patients and methodsMedical records were obtained from a prospective database of first-visit men with LUTS/BPH. Age, international prostate symptom score (IPSS), overactive bladder symptom score (OABSS), maximum urinary flow rate (Q max ), and post-void residual urine volume (PVR) were assessed. Total prostate volume (TPV), transition zone volume (TZV), transition zone index (TZI), and PZT were measured by transrectal ultrasonography. Reliability analysis was also performed. ResultsIn all, 1009 patients were enrolled for the analysis. The mean (SD) PZT was 11.10 (2.50) mm, and patients were classified into three groups PZT thickness groups; PZT <9.5 mm, ≥9.5 to <13 mm, and ≥13 mm. As the PZT became smaller, all urinary symptom scores including IPSS, quality of life (QoL), and OABSS significantly increased. Uroflowmetry variables, such as Q max and PVR, also showed significant differences. PZT showed a high intra-class correlation coefficient (0.896). Multivariate analysis revealed that the PZT was independently associated with IPSS (P < 0.001), QoL (P = 0.003), OABSS (P = 0.001), and PVR (P = 0.001), but PZT influence on Q max was only of borderline significance (P = 0.055). ConclusionPZT is a novel, easy-to-measure prostate parameter that is significantly associated with urinary symptoms. Our present findings suggest that clinical usefulness of PZT should be further validated for managing men with LUTS/BPH.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Clinical significance of peripheral zone thickness in men with lower urinary tract symptoms/benign prostatic hyperplasia

et al. 2015

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“…Moreover, urodynamic findings showed that only half of the patients demonstrated bladder outlet obstruction in LUTS patients with a small prostate volume (PV), indicating the heterogeneity of this disease [ 3 ]. For this reason, several anatomical prostatic factors, such as the transitional zone index (TZI) and prostatic urethral angle (PUA), rather than simple volume parameters, have been investigated [ 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

Clinical Significance of Periurethral Calcification According to the Location in Men With Lower Urinary Tract Symptoms and a Small Prostate Volume

et al. 2017

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Purpose:To assess the impact of periurethral calcification (PUC) according to its location on uroflowmetric parameters and urinary symptoms in patients with small prostate volume (PV). Methods: Records were obtained from a prospectively maintained database of first-visit men with lower urinary tract symptoms (LUTS). Patients whose PV was > 30 mL were excluded to elucidate more clearly the impact of PUC on LUTS. A total of 539 patients were enrolled in the study. The prostatic urethra was examined by transrectal ultrasonography for PUC, and the location of PUC was divided into 3 areas (proximal, mid, and distal). Results: The characteristics according to the location of PUC were compared using a 1-way analysis of variance test. The Total International Prostate Symptom Score (IPSS), postmicturition symptoms, and overactive bladder symptom score (OABSS) differed significantly among the groups. In the propensity score matching analysis, the proximal-and distal-PUC groups did not have a significantly different urinary flow rate or symptom score when compared to their matched control groups. However, the mid-PUC group had significantly worse urinary symptoms than its matched control group (total IPSS [P = 0.001], voiding symptoms [P = 0.002], storage symptoms [P = 0.041], and OABSS [P = 0.015]). The peak urinary flow rate was also lower in the mid-PUC group with borderline significance (P = 0.082). On multivariate linear regression analysis, mid-PUC was independently associated with IPSS and OABSS (P = 0.035 and P = 0.011, respectively). Conclusions: Only mid-PUC was associated with symptom severity in men with LUTS and a small PV. Our findings suggest that mid-PUC could be a potential causal factor of LUTS, and the midportion of the prostatic urethra might play a pivotal role in the process of micturition.

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“…The PUA determined with TRUS is the angle formed by two rays of the proximal and distal prostatic urethra on the midsagittal plane image. PUA is associated with urinary symptom severity and Qmax in men with LUTS and a small prostate volume 15. The correlation between PUA ≥35° and incidence of BOO was found to be significant in 260 men with LUTS/BPH 16.…”

Section: Rezūm® System – Convective Rf Water Vapor Thermal Therapymentioning

confidence: 90%

<div>Perspective on the Rezūm<sup>®</sup> System: a minimally invasive treatment strategy for benign prostatic hyperplasia using convective radiofrequency water vapor thermal therapy</div>

Woo¹,

González²

2017

MDER

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Convective radiofrequency (RF) water vapor thermal therapy is a minimally invasive office or outpatient procedure for the treatment of bothersome moderate-to-severe lower urinary tract symptoms associated with benign prostatic hyperplasia (BPH). It provides an option for patients seeking rapid and durable relief of urinary symptoms, improved quality of life, and preservation of sexual function as an alternative to long-term use of drugs and avoidance of the potential side effects of pharmaceuticals or invasive BPH surgery. The procedure is also applicable for the treatment of the median lobe or elevated bladder neck from central zone hyperplasia. This perspective presents a comprehensive overview of the Rezūm® System convective RF thermal therapy device, the principles upon which it is based, the operative procedure, and the clinical evidence accrued to this point in time.

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Correlation of Prostatic Urethral Angle with the Severity of Urinary Symptom and Peak Flow Rate in Men with Small Prostate Volume

Cited by 20 publications

References 22 publications

Clinical significance of peripheral zone thickness in men with lower urinary tract symptoms/benign prostatic hyperplasia

Clinical significance of peripheral zone thickness in men with lower urinary tract symptoms/benign prostatic hyperplasia

Clinical Significance of Periurethral Calcification According to the Location in Men With Lower Urinary Tract Symptoms and a Small Prostate Volume

<div>Perspective on the Rezūm<sup>®</sup> System: a minimally invasive treatment strategy for benign prostatic hyperplasia using convective radiofrequency water vapor thermal therapy</div>

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Correlation of Prostatic Urethral Angle with the Severity of Urinary Symptom and Peak Flow Rate in Men with Small Prostate Volume

Cited by 20 publications

References 22 publications

Clinical significance of peripheral zone thickness in men with lower urinary tract symptoms/benign prostatic hyperplasia

Clinical significance of peripheral zone thickness in men with lower urinary tract symptoms/benign prostatic hyperplasia

Clinical Significance of Periurethral Calcification According to the Location in Men With Lower Urinary Tract Symptoms and a Small Prostate Volume

<div>Perspective on the Rezūm<sup>&reg;</sup> System: a minimally invasive treatment strategy for benign prostatic hyperplasia using convective radiofrequency water vapor thermal therapy</div>

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Product

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<div>Perspective on the Rezūm<sup>®</sup> System: a minimally invasive treatment strategy for benign prostatic hyperplasia using convective radiofrequency water vapor thermal therapy</div>