Homma Y, Gotoh M, Takei M, Kawabe K, Yamaguchi T
Department of Urology, The University of Tokyo, Japan.
Int J Urol. 1998 Jan;5(1):61-6. doi: 10.1111/j.1442-2042.1998.tb00238.x.
The degree of bladder outlet obstruction (BOO) in benign prostatic hyperplasia (BPH) is most accurately quantified by pressure flow studies (PFS), although these studies are more invasive and complicated than conventional tests. We examined how precisely conventional tests predicted the PFS-assessed degree of BOO.
The study population consisted of 232 BPH patients who had undergone routine conventional tests and PFS. Correlation of the conventional test results with the degree of BOO assessed by PFS was examined by Spearman's correlation coefficients. Regression and subgroup analyses were performed to predict the degree of BOO using the conventional test results as the explanatory variables.
The degree of BOO correlated with prostate volume, the degree of endoscopic obstruction, and to a lesser extent, with the maximum flow rate (Qmax) and age. The predictability of conventional tests alone, or in combination, for BOO, was approximately 60% to 70%, which is not acceptable for investigational use. However, almost all patients with a prostate volume larger than 30 mL, or with severe obstruction on urethroscopic findings, had an obstructed bladder outlet.
PFS is mandatory when the precise evaluation of the degree of BOO is required, and patients are highly likely to have an outlet obstruction when they have a prostate larger than 30 mL, or severely obstructed posterior urethra on endoscopy.
良性前列腺增生（BPH）所致膀胱出口梗阻（BOO）的程度通过压力流率研究（PFS）能得到最准确的量化，尽管这些研究比传统检查更具侵入性且更复杂。我们研究了传统检查预测PFS评估的BOO程度的精确性。
研究人群包括232例接受了常规传统检查和PFS的BPH患者。通过Spearman相关系数检验传统检查结果与PFS评估的BOO程度之间的相关性。以传统检查结果作为解释变量进行回归分析和亚组分析以预测BOO程度。
BOO程度与前列腺体积、内镜下梗阻程度相关，在较小程度上与最大尿流率（Qmax）和年龄相关。单独或联合使用传统检查对BOO的预测性约为60%至70%，这对于研究用途而言是不可接受的。然而，几乎所有前列腺体积大于30 mL或尿道镜检查发现严重梗阻的患者都存在膀胱出口梗阻。
当需要精确评估BOO程度时，PFS是必需的，并且当患者前列腺体积大于30 mL或内镜检查发现后尿道严重梗阻时，极有可能存在出口梗阻。
