Singh Kawaljit, Sinha Rahul Janak, Sokhal Ashok, Singh Vishwajeet
Department of Urology, King George's Medical University, Lucknow, Uttar Pradesh, India.
Urol Ann. 2017 Jul-Sep;9(3):223-229. doi: 10.4103/0974-7796.210029.
Bladder outlet obstruction (BOO) in large and small prostates is managed in a similar manner despite considerably different pathophysiology, which can result in higher failure rates. We investigate the clinical and urodynamic features and study the outcome of patients with benign prostate hyperplasia (BPH) according to their prostate size.
We prospectively analyzed 100 BPH patients undergoing urodynamic study between January 2015 and August 2016 and divided them into two groups according to their prostate size: small (≤30 mL) and large prostate (>30 mL) groups. We compared the groups regarding age, International Prostate Symptom Score, maximal flow rate (Qmax), postvoided residual, serum prostate-specific antigen (PSA), prostate volume measured by ultrasonography (USG), and urodynamic findings.
For testing the hypothesis, we used the Chi-square test, Student's -test, and one-way analysis of variance when comparing between groups and conducted the logistic regression analysis for determining predictive factors of BOO.
Although the total prostate volume significantly correlated with the PSA, patients with a small prostate had lower Qmax (5.27 ± 4.8 mL/s vs. 6.14 ± 6.66 mL/s; = 0.74), higher incidence of abnormal baldder capacity (39.9% vs. 31.25%), lower voiding efficiency (39.3 ± 40.5% vs. 40.57 ± 32.11%), low compliance (44.4% vs. 31.3%), higher incidence of indeterminate detrusor contractions (38.9% vs. 37.5%), lower incidence of detrusor underactivity (33.3% vs. 28.1%), lower BOO index (40.9 ± 43.2 vs. 49.10 ± 44.48), lower bladder contractility index (77.8 ± 48.84 vs. 92.09 ± 52.79), and lower PdetQmax (51.44 ± 42.23 vs. 61.38 ± 42.01 cmHO). Small prostates had higher failed voiding trials postsurgery.
BOO patients with a small prostate showed poor urodynamic parameters and reported higher postoperative complications.
尽管大小前列腺导致的膀胱出口梗阻（BOO）病理生理机制差异很大，但其治疗方式相似，这可能导致更高的失败率。我们根据前列腺大小调查良性前列腺增生（BPH）患者的临床和尿动力学特征，并研究其治疗结果。
我们前瞻性分析了2015年1月至2016年8月间接受尿动力学研究的100例BPH患者，根据前列腺大小将他们分为两组：小前列腺组（≤30 mL）和大前列腺组（>30 mL）。我们比较了两组患者的年龄、国际前列腺症状评分、最大尿流率（Qmax）、排尿后残余尿量、血清前列腺特异性抗原（PSA）、超声测量的前列腺体积（USG）以及尿动力学检查结果。
为验证假设，我们在组间比较时使用了卡方检验、t检验和单因素方差分析，并进行了逻辑回归分析以确定BOO的预测因素。
尽管前列腺总体积与PSA显著相关，但小前列腺患者的Qmax较低（5.27±4.8 mL/s对6.14±6.66 mL/s；P = 0.74），膀胱容量异常发生率较高（39.9%对31.25%），排尿效率较低（39.3±40.5%对4
