Experience with Uroflowmetry in Evaluation of Lower Urinary Tract Symptoms in Patients with Benign Prostatic Hyperplasia

Singla, Suhas; Garg, Ramneesh; Singla, Ankit; Sharma, Sandeep; Singh, Jasdeep; Sethi, Pulkit

doi:10.7860/jcdr/2014/7909.4271

Cited by 13 publications

(7 citation statements)

References 9 publications

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“…Symptoms, such as a weak urine stream, could be the result of diseases originating from the bladder or bladder outlet. Further examinations, such as uroflowmetry or bladder sonography, are usually necessary to confirm the diagnosis [ 20 ]. LUTDs originating from the bladder include DO, interstitial cystitis/bladder pain syndrome (IC/BPS) and hypersensitive bladder.…”

Section: Mechanism Action Of Bont-a On Bladder Diseasementioning

confidence: 99%

Botulinum Toxin A and Lower Urinary Tract Dysfunction: Pathophysiology and Mechanisms of Action

Jhang

Kuo

2016

Toxins

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The use of onabotulinumtoxinA (BoNT-A) for the treatment of lower urinary tract diseases (LUTD) has increased markedly in recent years. The indications for BoNT-A treatment of LUTD now include neurogenic or idiopathic detrusor overactivity, interstitial cystitis/bladder pain syndrome and voiding dysfunction. The mechanisms of BoNT-A action on LUTDs affect many different aspects. Traditionally, the effects of BoNT-A were believed to be attributable to inhibition of acetylcholine release from the presynaptic efferent nerves at the neuromuscular junctions in the detrusor or urethral sphincter. BoNT-A injection in the bladder also regulated sensory nerve function by blocking neurotransmitter release and reducing receptor expression in the urothelium. In addition, recent studies revealed an anti-inflammatory effect for BoNT-A. Substance P and nerve growth factor in the urine and bladder tissue decreased after BoNT-A injection. Mast cell activation in the bladder also decreased. BoNT-A-induced improvement of urothelium function plays an important mitigating role in bladder dysfunction. Vascular endothelial growth factor expression in urothelium decreased after BoNT-A injection, as did apoptosis. Studies also revealed increased apoptosis in the prostate after BoNT-A injection. Although BoNT-A injection has been widely used to treat different LUTDs refractory to conventional treatment, currently, onabotulinumtoxinA has been proven effective only on urinary incontinence due to IDO and NDO in several large-scale clinical trials. The effects of onabotulinumtoxinA on other LUTDs such as interstitial cystitis, benign prostatic hyperplasia, dysfunctional voiding or detrusor sphincter dyssynergia have not been well demonstrated.

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Section: Mechanism Action Of Bont-a On Bladder Diseasementioning

confidence: 99%

Botulinum Toxin A and Lower Urinary Tract Dysfunction: Pathophysiology and Mechanisms of Action

Jhang

Kuo

2016

Toxins

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“…Kang et al [15] evaluated the clinical and urodynamic features of patients with lower urinary tract symptoms with BPE according to their prostate size and concluded that patients with a small prostate had better urodynamic outcomes than those with larger prostates in the overall population [15]. A similar study conducted by Singla et al [16] however concluded that bladder abnormalities including low compliance and involuntary detrusor contractility were similar among the 2 groups (small [<30 mL] and large [>80 mL] prostate) in BOO patients [16]. As prostate volume is not a reliable marker of BOO, we excluded this parameter from the analysis.…”

Section: Discussionmentioning

confidence: 99%

Effect of Transurethral Resection of the Prostate on Urodynamic Parameters in Patients with Benign Prostatic Enlargement with Upper Urinary Tract Dilatation

et al. 2021

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Objective: To evaluate the urodynamic outcomes of transurethral resection of the prostate (TURP) in patients of benign prostatic enlargement (BPE) with upper urinary tract dilatation and correlate with International Prostate Symptoms Score (I-PSS). Methods: In this prospective study, patients of BPE with upper urinary tract dilatation from July 2017 to June 2019 were enrolled. At presentation, detailed I-PSS, ultrasonography abdomen, serum creatinine, and serum PSA were recorded. All the patients were catheterized and observed for postobstructive diuresis. At 4 weeks, repeat ultrasound and serum creatinine were recorded. Urodynamic study (UDS) was performed after ensuring sterile urine culture. Patients underwent TURP as per the standard technique. A repeat UDS was performed after 3 months, and analysis was done. Results: Forty-four patients were enrolled of which data of 37 patients were analyzed. In the filling phase of the UDS, there was a significant decrease in detrusor pressure at the end filling phase from 27 to 9.0 cm H2O after TURP. Maximum cystometric capacity and bladder compliance significantly improved at 3 months following surgery. In the voiding phase, peak flow rate showed a significant increase, postvoid residual urine volume significantly decreased, and peak detrusor pressure marginally decreased following TURP. The I-PSS decreased from 20 ± 8 to 5 ± 6 following TURP. Conclusion: High detrusor pressure and reduced compliance is a risk factor for upper urinary tract dilatation. Changes in the bladder dynamics and resolution of hydronephrosis following TURP reflected in the changes in urodynamic parameters and I-PSS.

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“…A few studies showed a correlation between the IPSS (or IPSS categories) and the residue. 1,16,17,22 However, there were also some studies that did not find a correlation. 23 In our study, we were unable to show a significant correlation between these variables.…”

Section: Discussionmentioning

confidence: 99%

“…For the separate IPSS questions, we used the categories rarely (score 0-1), sometimes (score 2-3) and often (score 4-5). For the IPSS storage, we used the categories mild (score 0-5), moderate (score 6-10) and severe (score [11][12][13][14][15] and for the IPSS voiding mild (score 0-6), moderate (score 7-13) and severe (score [14][15][16][17][18][19][20]. In order to investigate whether the relationship differed per age category, we added the interaction for age categories.…”

Section: Statistical Analysesmentioning

confidence: 99%

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No Relationship Between the International Prostate Symptom Score and Post-Void Residual Volume in Primary Care

Lammers

Teunissen

Bor

et al. 2020

RRU

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Background: Lower urinary tract symptom (LUTS) is a common condition in older men. In accordance with the Dutch College of General Practitioners Guideline "Micturition symptoms in men", the diagnosis can be made based on a patient's medical history and a physical examination. GPs lack additional tools in primary care to assess the residual urine volume. A residual volume usually requires a referral to a urologist. We hypothesized that the IPSS screening questionnaire score (measuring the severity of symptoms) might be related to patients' residual urine volume. The research objective was to examine the relation between the IPSS score and the residual urine volume. Methods: In a cross-sectional study, we analysed patients' IPSS and residual urine volume. Men aged over 50 with LUTS who consulted Dutch primary-care physicians were included. The interventions comprised an IPSS screening and a bladder scan. Data regarding the patients' residual volume, total IPSS score, single IPSS score, IPSS storage score, and IPSS voiding score were recorded and analysed. We used odds ratios to describe the relation between the IPSS categories associated with the presence of a normal or abnormal (above 100 cc and above 200 cc) residual urine volume. Results: A total of 126 patients were included in this study. Patients with higher scores on the overall IPSS, separate IPSS, IPSS storage and IPSS voiding showed no higher odds ratios of having an abnormal residual volume, neither above 100 mL or 200 mL. Conclusion: We did not find a relation between the IPSS core to an abnormal residual urine volume in men aged over 50 with LUTS consulting primary-care physicians. Trial Registration: This study has been approved by the Central Committee on Research Involving Human Subjects for the Arnhem-Nijmegen Region and is registered with ToetsingOnline under ID number 29822.091.10.

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Experience with Uroflowmetry in Evaluation of Lower Urinary Tract Symptoms in Patients with Benign Prostatic Hyperplasia

Cited by 13 publications

References 9 publications

Botulinum Toxin A and Lower Urinary Tract Dysfunction: Pathophysiology and Mechanisms of Action

Botulinum Toxin A and Lower Urinary Tract Dysfunction: Pathophysiology and Mechanisms of Action

Effect of Transurethral Resection of the Prostate on Urodynamic Parameters in Patients with Benign Prostatic Enlargement with Upper Urinary Tract Dilatation

<p>No Relationship Between the International Prostate Symptom Score and Post-Void Residual Volume in Primary Care</p>

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