Department of Urology, Korea University School of Medicine, Seoul, Korea.
Int Neurourol J. 2010 Dec;14(4):238-44. doi: 10.5213/inj.2010.14.4.238. Epub 2010 Dec 31.
Although post-void residual urine (PVR) is frequently utilized clinically in patients with benign prostatic hyperplasia (BPH), mainly because of its procedural simplicity, its role as a clinical prognostic factor, predictive of treatment goals, is still under much dispute. We investigated the predictive value of PVR for BPH-related clinical events including surgery, acute urinary retention (AUR), and admission following urinary tract infection (UTI).
From January to June of 2006, patients over 50 years of age who were diagnosed with BPH for the first time at the outpatient clinic and were then treated for at least 3 years with medications were enrolled in this study. The variables of patients who underwent surgical intervention for BPH, had occurrences of AUR, or required admission due to UTI (Group 1, n=43) were compared with those of patients who were maintained with medications only (Group 2, n=266).
Group 1 had a significantly higher PVR, more severe symptoms, and a larger prostate at the time of the initial diagnosis in both the univariate and the multivariate analysis. In the 39 patients who underwent BPH-related surgery, although there was a significant change in Qmax at the time of surgery (mean, 13.1 months), PVR and the symptom score remained unchanged compared with the initial evaluation. In the receiver-operating characteristic curve analysis, the area under the curve of Group 1 was in the order of prostate volume (0.834), PVR (0.712), and symptom score (0.621). When redivided by arbitrarily selected PVR cutoffs of 50 mL, 100 mL, and 150 mL, the relative risk of clinical BPH progression was measured as 3.93, 2.61, and 2.11.
These data indicate that, in the symptomatic Korean population, increased PVR at baseline is a significant indicator of BPH-related clinical events along with increased symptom score or prostate volume.
尽管在患有良性前列腺增生症（BPH）的患者中，经常使用残余尿（PVR）进行临床检测，主要是因为其检测程序简单，但它作为一种临床预后因素，预测治疗目标的作用仍存在很大争议。我们研究了 PVR 对 BPH 相关临床事件的预测价值，包括手术、急性尿潴留（AUR）和尿路感染（UTI）后的入院。
2006 年 1 月至 6 月，在门诊首次诊断为 BPH 且随后接受药物治疗至少 3 年的 50 岁以上患者被纳入本研究。比较接受 BPH 手术、发生 AUR 或因 UTI 而需要入院治疗的患者（组 1，n=43）的患者变量与仅接受药物治疗的患者（组 2，n=266）。
在单因素和多因素分析中，组 1 的 PVR 更高，症状更严重，且在初始诊断时前列腺更大。在 39 例接受 BPH 相关手术的患者中，尽管手术时 Qmax 有明显变化（平均 13.1 个月），但与初始评估相比，PVR 和症状评分保持不变。在受试者工作特征曲线分析中，组 1 的曲线下面积按前列腺体积（0.834）、PVR（0.712）和症状评分（0.621）的顺序排列。当按任意选择的 PVR 截断值 50mL、100mL 和 150mL 重新划分时，临床 BPH 进展的相对风险分别为 3.93、2.61 和 2.11。
这些数据表明，在有症状的韩国人群中，基线时 PVR 增加是 BPH 相关临床事件的重要指标，与症状评分或前列腺体积增加有关。
