Prostatic Urethral Angulation Associated With Urinary Flow Rate and Urinary Symptom Scores in Men With Lower Urinary Tract Symptoms

Bang, Woo Jin; Kim, Hong Wook; Lee, Joo Yong; Lee, Dae Hoon; Hah, Yoon Soo; Lee, Hyung Ho; Koo, Kyo Chul; Yu, Ho Song; Ham, Won Sik; Cho, Kang Su

doi:10.1016/j.urology.2012.08.058

Cited by 32 publications

(30 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our study showed no significant difference in Qmax values in the two groups of patients (p-value = 0.45) ( Table 1). In contrast to our findings, the urinary flow rate was found inversely associated with the PUA (11), and a larger PUA was associated with a lower urinary flow rate (14). On the other hand, no significant difference in Qmax values between patients with PUA more or less 35ẘ as reported (12).…”

Section: Discussioncontrasting

confidence: 96%

“…Patients with PUA ≥ 35° had larger prostate volume and higher BOO index, in comparison with those who had PUA < 35° (12). Further studies showed that the PUA is significantly associated with maximum flow rate (Qmax) and voiding symptom scores in men with LUTS (13)(14). In terms of medical therapy for BPH several drugs are widely distributed in the market and selective α1-blocker is the recommended treatment (15).…”

mentioning

confidence: 99%

See 1 more Smart Citation

Clinical significance of prostatic-urethral angulation on the treatment outcome of patients with symptomatic benign prostatic hyperplasia treated with tamsulosin hydrochloride

El-Tatawy

Gameel

El-enen

et al. 2015

Arch Ital Urol Androl

View full text Add to dashboard Cite

SummaryNo conflict of interest declared.Up till now the exact pathophysiology of BPH is still poorly understood and different theories have emerged and changed over the past years. Some studies reported that the prostate volume does not correlate with the clinical LUTS and/or the degree of bladder outlet obstruction (BOO) (2, 3), and other studies discussed several anatomical factors that may explain the clinical effect of BPH such as intravesical prostatic protrusion (IPP), transition zone volume (TZV), transition zone index (TZI) and presumed circle area ratio (4-9). Recently, Cho et al. introduced the term prostatic-urethral angulation (PUA) as a new measurement that could be a causal factor for BPH (10), and in their subsequent preliminary clinical study using the fluid dynamic model, they reported that the urinary flow rate decreased by more than 27% as the PUA increased from 35° to 90° (11). Patients with PUA ≥ 35° had larger prostate volume and higher BOO index, in comparison with those who had PUA < 35° (12). Further studies showed that the PUA is significantly associated with maximum flow rate (Qmax) and voiding symptom scores in men with . In terms of medical therapy for BPH several drugs are widely distributed in the market and selective α1-blocker is the recommended treatment (15). Tamsulosin hydrochloride is a highly selective α1A-blocker that is currently used and proved to be effective and safe in treatment of symptomatic BPH alone or in combination with other drugs (16). The effect of PUA on the treatment outcome of tamsulosin hydrochloride on men with LUTS was first evaluated and PUA was inversely correlated with changes in Qmax and symptoms score after treatment (17). The aim of the present study is to evaluate the clinical outcome of medical treatment (by selective α1A-blocker) on male patients presented with LUTS/BPH and its correlation to the degree of PUA.

show abstract

Section: Discussioncontrasting

confidence: 96%

mentioning

confidence: 99%

Clinical significance of prostatic-urethral angulation on the treatment outcome of patients with symptomatic benign prostatic hyperplasia treated with tamsulosin hydrochloride

El-Tatawy

Gameel

El-enen

et al. 2015

Arch Ital Urol Androl

View full text Add to dashboard Cite

show abstract

“…We first suggested in 2008 that the PUA is a causal factor of LUTS/BPH based on a fluid dynamic model and mathematical simulation. Subsequently, we also showed that the PUA significantly associates with the Qmax and symptom scores in men with LUTS [8], [14], [15]. In a retrospective study of 270 LUTS/BPH patients by Park et al [16], an increased PUA is associated with an aggravation of voiding symptom.…”

Section: Discussionsupporting

confidence: 52%

“…The PUA was defined as the angle formed by 2 rays of both proximal and distal prostatic urethra on the midsagittal plane image, and which was taken with the posterior wall of the prostate positioned as flat as possible to minimize the influence of pressure from the rectal probe as shown in Fig. 2 [8], [12]. Two independent urologists (DHK and JYL) calculated the PUA, and the average of these two values was scored for greater accuracy.…”

Section: Methodsmentioning

confidence: 99%

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

Kang¹,

Lee

Hah

et al. 2014

PLoS ONE

Self Cite

View full text Add to dashboard Cite

PurposeTo evaluate the effects of prostatic anatomical factors on male lower urinary tract symptoms (LUTS) and the peak flow rate (Qmax) in patients with small prostate volume (PV).Materials and MethodsRecords were obtained from a prospectively maintained database of first-visit men with LUTS. Patients whose total PV (TPV) was greater than 30 mL were excluded; 444 patients were enrolled in the study. The TPV, transitional zone volume (TZV), transitional zone index (TZI), intravesical prostatic protrusion (IPP), and prostatic urethral angle (PUA) were measured by transrectal ultrasonography. LUTS were evaluated using the International Prostate Symptom Score (IPSS) and the Overactive Bladder Symptom Score (OABSS) questionnaires. Uroflowmetric measurements were also made.ResultsPUA (r = 0.269, P<0.001), TZV (r = 0.160, P<0.001), and TZI (r = 0.109, P = 0.022) significantly correlated with the IPSS. Qmax (r = −0.334, P<0.001) and OABSS (r = 0.211, P<0.001) correlated only with PUA. In a multivariate regression analysis, PUA and age were independently associated with IPSS, OABSS, and Qmax. For IPSS of 20 or greater, the area under the ROC curve (AUC) of PUA was 0.667 and the cut-off value was 43.7°. When Qmax was 10 mL/s or less, the AUC of PUA was 0.664 and the cut-off value was 43.5°.ConclusionsPUA has a significant association with symptom severity and Qmax among prostatic anatomical factors analyzed in men with LUTS and small PV. PUA should be considered as an important clinical factor in male LUTS management. Furthermore, the impact of PUA on response to medical treatment and disease progression needs to be investigated.

show abstract

“…LUTS secondary to BPH generally consists of three components: benign proliferation of the stroma and epithelium, bladder outlet obstruction and symptoms resulting from obstruction. 5 BPH has been considered to be one of the most important risk factors for LUTS; 6 however, it is becoming increasingly recognized that the origin of LUTS is multifactorial resulting from more than prostate enlargement. 7,8 We propose that the autonomic nervous system plays an important role in the development of LUTS.…”

Section: Introductionmentioning

confidence: 99%

Nerve growth factor signaling following unilateral pelvic ganglionectomy in the rat ventral prostate is age dependent

Podlasek

Ghosh²,

Çakır³

et al. 2013

Asian J Androl

View full text Add to dashboard Cite

Benign prostatic hyperplasia (BPH) is a serious health concern and is an underlying cause of lower urinary tract symptoms (LUTS) in many men. In affected men, LUTS/BPH is believed to result from benign proliferation of the prostate resulting in bladder outlet obstruction. Postnatal growth of the prostate is controlled via growth factor and endocrine mechanisms. However, little attention had been given to the function of the autonomic nervous system in prostate growth and differentiation. Nerve growth factor (NGF) is a prostatic mitogen that has a trophic role in autonomic sensory end organ interaction. In this study, we examine how the autonomic nervous system influences prostate growth as a function of age by quantifying NGF in the rat ventral prostate (VP) after pelvic ganglionectomy. Unilateral pelvic ganglionectomy was performed on postnatal days 30 (P30), 60 and 120 Sprague-Dawley rats in comparison to sham controls (n539). Semiquantitative RT-PCR, Western blotting and immunohistochemical analysis for NGF were performed on denervated, intact (contralateral side) and sham control VP 7 days after surgery. Ngf RNA expression was significantly increased in the denervated and intact hyperplastic VP. Western blotting showed age-dependent increases in NGF protein at P60 in the contralateral intact VP. NGF was localized in the nerves, basal cells and columnar epithelium of the prostatic ducts. Denervation causes age-dependent increases in NGF in the VP, which is a potential mechanism by which the autonomic nervous system may regulate prostate growth and lead to BPH/LUTS. Asian Journal of Andrology (2013) Keywords: denervation; nerve growth factor; prostate growth; ventral prostate INTRODUCTION Benign prostatic hyperplasia (BPH) is a serious health concern worldwide and is an underlying cause of many lower urinary tract symptoms (LUTS). LUTS is common in aging men and a population based survey performed in five countries reports that ,64% of adults experience at least one LUTS symptom.1 LUTS has a profound impact on social functioning and quality of life in affected men 2,3 with similar effects reported as after a heart attack or stroke.4 BPH can induce acute urinary retention, incontinence, recurrent urinary tract infection or obstructive uropathy. LUTS secondary to BPH generally consists of three components: benign proliferation of the stroma and epithelium, bladder outlet obstruction and symptoms resulting from obstruction.

show abstract

Prostatic Urethral Angulation Associated With Urinary Flow Rate and Urinary Symptom Scores in Men With Lower Urinary Tract Symptoms

Cited by 32 publications

References 15 publications

Clinical significance of prostatic-urethral angulation on the treatment outcome of patients with symptomatic benign prostatic hyperplasia treated with tamsulosin hydrochloride

Clinical significance of prostatic-urethral angulation on the treatment outcome of patients with symptomatic benign prostatic hyperplasia treated with tamsulosin hydrochloride

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

Nerve growth factor signaling following unilateral pelvic ganglionectomy in the rat ventral prostate is age dependent

Contact Info

Product

Resources

About