Terminal dribbling in male patients with lower urinary tract symptoms: relationship with International Prostate Symptom Score and with intravesical prostatic protrusion

Kim, Jae Heon; Shim, Ji Sung; Choi, Hoon; Moon, Du Geon; Lee, Jeong Gu; Kim, Je Jong; Bae, Jae Hyun; Park, Jae Young

doi:10.1186/s12894-015-0082-x

Cited by 7 publications

(6 citation statements)

References 21 publications

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“…IPP is a promising parameter, first described by Chia in 200, 313, that has shown a good correlation with the presence and severity of BPO on urodynamic testing. Further studies have found a strong correlation between IPP and DO, bladder compliance, detrusor pressure at maximum urinary flow, terminal dribbling, BOO index and PVR while a negative correlation was found between IPP and Qmax and/or alpha-blockers efficacy [ 16 , 19 , 20 , 23 ]. Moreover a well-designed study from Luo GC et al has shown that the presence of middle lobe is more obstructive than those of lateral lobes and could better correlate with BOO grade [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

Intravescical prostatic protrusion is a predictor of alpha blockers response: results from an observational study

et al. 2018

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BackgroundTo investigate the efficacy of tamsulosin in patients with lower urinary tract symptoms (LUTS) and benign prostatic enlargement (BPE) with intravesical prostatic protrusion (IPP). Ultrasound measurement of the IPP has been previously described as an effective instrument for the evaluation of benign prostatic obstruction (BPO) and could help in clarifying the role of alpha-blockers in patients with (BPE).MethodsPatients with BPE and LUTS were enrolled in this observational study. Intravesical prostatic protrusion was graded as grade 1 (< 5 ml), 2 (5 < IPP < 10 ml) and 3 (> 10 ml). Patients were treated with tamsulosin for twelve weeks. Evaluation was performed before and at the end of treatment by means of International Prostate Symptom Score (IPSS) and uroflowmetry. Patients were considered responders if a reduction of IPSS > 3 points was reported.ResultsOne hundred forty-two patients were enrolled. Twelve patients were excluded because of incomplete data. Fifty patients showed an IPP grade 1 (group A), 52 a grade 2 (group B) and 28 a grade 3 (group C). Treatment success was obtained in 82%, 38,5% and 7,1% of patients respectively; these differences (group A vs B-C and group B vs C) were highly significant. The odd ratio to obtain a treatment success was of 59 and 8.1 in group A and group B respectively, in comparison to group C. After a multivariate regression, the relationship between IPP grade and treatment success remained significant. Improvement of uroflowmetry parameters has been reported in all the groups especially in patients with a low grade IPP (p value = 0,016 group A vs group B; p value = 0,005 group A vs group C). Prostate volume seems not to influence this relationship.ConclusionsIntravesical prostatic protrusion has found to be significantly and inversely correlated with treatment success in patients with LUTS and BPE under alpha-blockers therapy. Alpha blockers odd ratio of success is 59 times higher in patients with a low grade IPP in comparison to patients with a high grade.

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Section: Discussionmentioning

confidence: 99%

Intravescical prostatic protrusion is a predictor of alpha blockers response: results from an observational study

et al. 2018

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“…A further explanation may be preoperative terminal dribble (TD), which has been reported in 39.1% of men older than 40 years. In 27.2% of these men, TD was also objectively demonstrated [ 35 ].…”

Section: Discussionmentioning

confidence: 99%

The Role of Preoperative Puborectal Muscle Function Assessed by Transperineal Ultrasound in Urinary Continence Outcomes at 3, 6, and 12 Months After Robotic-Assisted Radical Prostatectomy

Neumann

O’Callaghan

2018

Int Neurourol J

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PurposeThe efficacy of pelvic floor muscle training (PFMT) for men with postprostatectomy incontinence (PPI) after robotic-assisted radical prostatectomy (RARP) is controversial and the mechanism for its possible effect remains unclear. The aim of this study was to investigate the relationship between bladder neck (BN) displacement, as a proxy for puborectal muscle activation, and continence outcomes after RARP.MethodsData were extracted from the South Australian Prostate Cancer Clinical Outcomes Collaborative database for men undergoing RARP by high volume surgeons who attended preoperative pelvic floor physiotherapy for pelvic floor muscle (PFM) training between 2012 and 2015. Instructions were to contract the PFM as if stopping the flow of urine. BN displacement was measured with 2-dimensional transperineal ultrasound, without digital rectal examination. Urinary continence status was assessed preoperatively and at 3, 6, and 12 months using the Expanded Prostate Cancer Index Composite 26. Data were analysed using logistic regression and mixed effects linear modelling. Confounding variables considered were baseline continence, age at diagnosis, margin status, nerve sparing procedures and pathological stage.ResultsOf 671 eligible men, 358 met the inclusion criteria and were available for analysis, with 136 complete datasets at 12-month follow-up. While BN movement was associated with preoperative continence, there was no significant effect of BN displacement on the change in urinary continence at 12 months postprostatectomy (P=0.81) or on the influence of time on continence over 3–12 months.ConclusionsContinence outcomes were not associated with BN displacement, produced by activity of the puborectal portion of the levator ani muscle, at 3, 6, or 12 months after RARP. These results suggest that the puborectal muscle does not play a role in the recovery of continence after RARP and may help to explain the negative findings of many studies of PFMT for PPI.

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“…Despite the discrepancies, voiding times recorded by standard uroflowmetry and computer-vision uroflowmetry had a high linear correlation with the number of video frames (Pearson's r = 0.96). We believe that inconsistencies with regard to terminal dribbling can provide valuable information about the prostate and bladder functions 49 .…”

Section: Computer-vision Uroflowmetermentioning

confidence: 95%

A mountable toilet system for personalized health monitoring via the analysis of excreta

et al. 2020

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Technologies for the longitudinal monitoring of a person's health are poorly integrated with clinical workflows, and have rarely produced actionable biometric data for healthcare providers. Here, we describe easily deployable hardware and software for the long-term analysis of a user's excreta through data collection and models of human health. The 'smart' toilet, which is selfcontained and operates autonomously by leveraging pressure and motion sensors, analyses the user's urine using a standard-of-care colorimetric assay that traces red-green-blue values from images of urinalysis strips, calculates the flow rate and volume of urine using computer vision as a uroflowmeter, and classifies stool according to the Bristol stool form scale using deep learning, with performance that is comparable to the performance of trained medical personnel. Each user of the toilet is identified through their fingerprint and the distinctive features of their anoderm, and the data are securely stored and analysed in an encrypted cloud server. The toilet may find uses in the screening, diagnosis and longitudinal monitoring of specific patient populations.

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Terminal dribbling in male patients with lower urinary tract symptoms: relationship with International Prostate Symptom Score and with intravesical prostatic protrusion

Cited by 7 publications

References 21 publications

Intravescical prostatic protrusion is a predictor of alpha blockers response: results from an observational study

Intravescical prostatic protrusion is a predictor of alpha blockers response: results from an observational study

The Role of Preoperative Puborectal Muscle Function Assessed by Transperineal Ultrasound in Urinary Continence Outcomes at 3, 6, and 12 Months After Robotic-Assisted Radical Prostatectomy

A mountable toilet system for personalized health monitoring via the analysis of excreta

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