Does Anamnestic Symptom Evaluation or Clinical Examination Give Enough Information to Evaluate the Severity of Obstruction in Benign Prostatic Hyperplasia?

Abstract

In this study we have investigated 70 men fulfilling the usual criteria accepted for transurethral resection of the prostate (TURP). The anamnestic evaluation included the Madsen-Iversen symptom score and a quality of life questionnaire. The clinical examination included suprapubic pressure flow measurement, free urinary flow, the determination of residual urine and the ultrasound evaluation of the size of the prostate. The clinical data were correlated with the grade of obstruction according to Schäfer calculated from the pressure/flow studies. No correlation was found between the grade of obstruction and anamnestic symptom data, the size of the prostate or residual urine. A slight correlation was found between the Schäfer grade of obstruction and the flow curve pattern or peak flow.

How to select patients suitable for transurethral microwave thermotherapy: a systematic evaluation of potentially predictive variables

“…Others have severe symptoms but a pressure‐flow study may show no obstruction. There is a poor correlation between urodynamically assessed outlet obstruction on the one hand, and clinical symptoms, PVR, the findings on DRE and uroflowmetry on the other [ 23, 24]. Jørgensen et al have also shown that elderly men tolerate many of the symptoms regarded as signs of prostatism [ 25].…”

Peut-on évaluer le débit urinaire maximal et le résidu postmictionnel par l’échelle visuelle analogique (EVA) ? Une étude prospective chez 31 patients

“…Dans la population étudiée, il n'a été constaté de corrélation du débit maximum mesuré (Q max ) ni avec la sensation de mauvaise vidange vésicale, ni avec le RPM mesuré. Ces résultats sont en concordance avec plusieurs études qui ont montré qu'il n'existait pas d'association entre l'obstruction sous-vésicale et le RPM [23,24]. La phase de compensation par augmentation du travail vésical pourrait expliquer une vidange normale malgré un obstacle sous-vésical [25].…”

α₁-Blocker Therapy for Lower Urinary Tract Symptoms Suggestive of Benign Prostatic Obstruction: What Are the Relevant Differences in Randomised Controlled Trials?

“…Additionally, both the valuation of discomfort as bother and the ability (sensitivity) to sense and express differences thereof may vary substantially among patients [45]. There is general agreement that subjective assessment of disease severity does not agree with objective measurements [46, 47, 48, 49, 50]and that this generally weak relationship might be increasingly confounded by old age [51]. Therefore subjective evaluations in the context of RCTs need to be amended and endorsed by objective evaluations, even if symptomatic discomfort correlates poorly with objective measures [52].…”