Thekumpadam Puthenveetil Rajeev, Baishya Debajit, Barua Sasanka, Sarma Debanga
Department of Urology, Gauhati Medical College Hospital, Guwahati, Assam, India.
Asian J Urol. 2015 Oct;2(4):233-237. doi: 10.1016/j.ajur.2015.08.004. Epub 2015 Sep 3.
The prevalence of benign prostatic hyperplasia (BPH) rapidly increases after the 4th decade of life. The combination of tamsulosin and dutasteride is a well established therapy for BPH of ≥40 g. Non-invasive urodynamic parameters can predict the outcome of medical therapy in patients with BPH. We aimed to correlate these parameters with treatment responses in BPH patients under medical management.
A prospective study was conducted in the Department of Urology in our hospital from May 2014 to April 2015. A total of 100 patients with BPH ≥40 g who fulfilled our inclusion criteria were included. Treatment responses were determined by the International Prostate Symptom Score (IPSS) and uroflowmetry. Transabdominal ultrasonography with Doppler was performed to measure prostate volume, intravesical prostatic protrusion (IPP), detrusor wall thickness (DWT), the prostatic capsular artery resistive index (RI) and prostatic urethral angle (PUA) before and 3 months after combination therapy of tamsulosin and dutasteride. Treatment responses were correlated with non-invasive urodynamic parameters.
The IPSS, uroflow, age, prostate volume, RI, IPP, DWT and PUA were correlated before and after treatment. Of the 100 patients, 70 (70%) showed significant improvement and 30 (30%) showed no improvement with therapy.
Ultrasound bladder parameters are useful tools for measuring the treatment response in BPH patients. Our study shows that RI and DWT significantly correlate with the treatment response in BPH patients. More importantly, pretreatment values of increased IPP and PUA determines the non-improvement of symptoms in BPH patients. Our study suggests the importance of transabdominal ultrasonography (KUB-P) with Doppler for evaluating treatment responses to medical management.
良性前列腺增生（BPH）的患病率在40岁以后迅速上升。坦索罗辛和度他雄胺联合用药是治疗前列腺体积≥40g的BPH的一种成熟疗法。非侵入性尿动力学参数可以预测BPH患者药物治疗的结果。我们旨在将这些参数与接受药物治疗的BPH患者的治疗反应相关联。
2014年5月至2015年4月在我院泌尿外科进行了一项前瞻性研究。共纳入100例符合纳入标准的前列腺体积≥40g的BPH患者。通过国际前列腺症状评分（IPSS）和尿流率测定来确定治疗反应。在坦索罗辛和度他雄胺联合治疗前及治疗3个月后，采用经腹超声多普勒测量前列腺体积、膀胱内前列腺突入（IPP）、逼尿肌壁厚度（DWT）、前列腺包膜动脉阻力指数（RI）和前列腺尿道角（PUA）。治疗反应与非侵入性尿动力学参数相关联。
治疗前后IPSS、尿流率、年龄、前列腺体积、RI、IPP、DWT和PUA均具有相关性。100例患者中，70例（70%）治疗后有显著改善，30例（30%）治疗后无改善。
超声膀胱参数是衡量BPH患者治疗反应的有用工具。我们的研究表明，RI和DWT与BPH患者的治疗反应显著相关。更重要的是，IPP和PUA升高的治疗前值决定了BPH患者症状无改善。我们的研究表明经腹超声（KUB-P）联合多普勒评估药物治疗反应的重要性。
