The significance of age on symptoms and urodynamic- and cystoscopic findings in benign prostatic hypertrophy

Abstract

To evaluate influence of age on symptomatology and objective parameters in benign prostatic hypertrophy, preoperative findings in 199 unselected patients during one year were analysed. Symptoms of bladder instability increased with age, as did incidence of uninhibited detrusor contractions and bladder trabeculation, whereas maximum urine flow and obstructive complaints decreased, although prostatic size was the same. In the oldest age groups only was increasing prostatic size associated with increasing bladder trabeculation. Age related changes in neurological control and in the structure of the bladder may be involved, and the present results suggest age to be an important factor in the interpretation of symptoms and objective findings in prostatic hypertrophy.

Antidiuretic hormone in elderly male patients with severe nocturia: a circadian study

“…Mean ( SD , range) total PSA and free PSA levels were 2.18 (1.76, 0.08-5.15) and 0.07 (0.54, 0.026-1.30) ng/mL, respectively. The IPSS was 15.67 (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)). …”

“…Nocturia was once regarded as an irritative or filling symptom, and closely associated with BPH and BOO [8,9]. However, various medical or surgical therapies for BPH or BOO do not improve nocturia [10].…”

Objective and Subjective Response Criteria to Diagnose Benign Prostatic Hyperplasia

“…This would result in an additional 9% of patients who were excluded from surgery because their pathologic Qmax is based on a decompensated or weak detrusor muscle and not on BPH, and reduces the failure rate based on global subjective assessment of outcome to 8.3%. max* Simonsen et al [10] found a correlation max* Until prospective randomized trials can be estab lished, the value of pressure-flow studies in correctly pre dicting patients with a successful versus an unsuccessful outcome should probably best be reserved for patients with an equivocal Qmax or those patients in whom the results of symptom score assessment and flow rate mea surements are discrepant. Furthermore, the urodynamic community's responsibility is to establish intra-individ ual values, to decrease examiner variability of the test and to establish guidelines as to the proper conduct of these studies.…”

“…An evaluation such as this could simply con sist of a digital rectal examination (anatomical hyperpla sia), flow rate measurement and PVR measurement (subvesical outlet obstruction), and the administration of a Response Criteria 10 Roehrborn…”

“…Similarly, other authors found no correlation between the size of the resected prostate specimen and the degree of flow rate impairment as determined by nomo grams [8,9], While large-scale population-based studies clearly identify a correlation between the weight of the prostate and age, in smaller individual series oftentimes no clear correlation between the weight of the resected specimen and the patient's age can be detected [7,10]. Simonsen et al [10] also did not find a correlation between obstructive symptoms as described by the pa tient and objective parameters such as the length of the prostatic urethra as a proxy for prostatic weight and the estimated weight of the prostate gland. Dorflinger et al [11] evaluated 84 patients with symptoms of BPH.…”