Detrusor blood flow as a measure of bladder outlet obstruction in patients with benign prostatic hyperplasia

ABSTRACT

In patients with benign prostatic hyperplasia [BPH], detrusor blood flow was evaluated by color Doppler ultrasonography [CDU] with the aim of revealing its possible usefulness as a measure of bladder outlet obstruction [BOO]. A total number of 30 men with lower urinary tract symptoms [LUTS] suggestive of BPH underwent pressure flow study [PFS] and detrusor CDU. Pulsatile blood flow was measured at three sites, the anterior bladder wall and the two lateral walls, and detrusor resistive index [DRI] was calculated. The findings were compared between patients with and without BOO. Between patients with and without BOO, there were significant differences for age [69.2 Vs. 62.1 years, p<0.005], PSA [3.9 Vs 2.6, p<0.05], prostate volume [45.5 Vs, 34.7, p<0.05], bladder wall thickness [5.6 Vs 3.2, p<0.001], blood flow detection [16/18 Vs 3/12, p<0.001] and DRI [0.82 by 0.65, p<0.005]. BOO was detected with a diagnostic accuracy of 83.3% [25/30] by CDU. Color Doppler ultrasonography has the promise to become a possible indicator for the diagnosis of BOO. To ascertain its clinical utility in terms of BOO predictability, a prospective study in a large cohort is needed