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[良性前列腺增生监测中逼尿肌厚度、膀胱内前列腺突出与最大尿流率之间的相关性]

[Correlation between detrusor thickness, intravesical prostatic protrusion and maximum urinary flow in the monitoring of benign prostatic hyperplasia].

作者信息

Boulma Rami, Charfi Mehdi, Trigui Mohamed, Daoud Mohamed Fares, Sahnoun Moez, Bouhaouala Mohamed Habib, Chouchen Adnen

机构信息

Service d'urologie, hôpital FSI La Marsa, Tunis, Tunisie.

Service de radiologie, hôpital FSI La Marsa, Tunis, Tunisie.

出版信息

Prog Urol. 2022 Mar;32(4):291-297. doi: 10.1016/j.purol.2021.10.004. Epub 2021 Nov 18.

Abstract

INTRODUCTION

Detrusor thickness (DT) and intravesical prostatic protrusion (IPP) are closely related to bladder outlet obstruction. The aim of our study was to look for correlation between DT, IPP and maximum urinary flow (Qmax).

METHODS

It is a prospective, observational study including men over fifty managed for benign prostatic hyperplasia. Low urinary tract symptoms were assessed with the International Prostatic Symptom Score (IPSS). Pelvic ultrasound was performed for all patients measuring prostatic volume, bladder volume, post- void residual, DT and IPP. Uroflowmetry was performed for all patients, Qmax was noted. Qmax equal or less than 15ml/s was considered pathologic.

RESULTS

Sixty patients were included for our study. Strong negative correlation was noted between DT, IPP and Qmax (r=-0.59, r=-0.61 respectively). Patients with pathologic Qmax had higher DT and IPP than those with normal Qmax, the difference was significant (P<0.01). Threshold values predicting pathologic Qmax were 3mm for DT and 7mm for IPP. ROC analysis reveals for DT an AUC of 0.84 (95% CI 0.76-0.92) and for IPP an AUC of 0.88 (95% CI 0.80-0.97).

CONCLUSION

Detrusor thickness and intravesical prostatic protrusion have strong negative correlation with Qmax. These parameters could be an alternative to Qmax measurement if uroflowmetry is unavailable.

LEVEL OF EVIDENCE

Grade B.

摘要

引言

逼尿肌厚度(DT)和膀胱内前列腺突出(IPP)与膀胱出口梗阻密切相关。我们研究的目的是寻找DT、IPP与最大尿流率(Qmax)之间的相关性。

方法

这是一项前瞻性观察性研究,纳入了50岁以上因良性前列腺增生接受治疗的男性。采用国际前列腺症状评分(IPSS)评估下尿路症状。对所有患者进行盆腔超声检查,测量前列腺体积、膀胱体积、残余尿量、DT和IPP。对所有患者进行尿流率测定,记录Qmax。Qmax等于或小于15ml/s被视为病理性的。

结果

我们的研究纳入了60例患者。DT、IPP与Qmax之间存在强负相关(分别为r = -0.59,r = -0.61)。病理性Qmax的患者比Qmax正常的患者DT和IPP更高,差异具有统计学意义(P < 0.01)。预测病理性Qmax的阈值DT为3mm,IPP为7mm。ROC分析显示DT的AUC为0.84(95%CI 0.76 - 0.92),IPP的AUC为0.88(95%CI 0.80 - 0.97)。

结论

逼尿肌厚度和膀胱内前列腺突出与Qmax呈强负相关。如果无法进行尿流率测定,这些参数可作为Qmax测量的替代方法。

证据水平

B级。

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