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Intravesical protrusion of the prostate as a predictive method of bladder outlet obstruction
Reis, Leonardo O; Barreiro, Guilherme C; Baracat, Jamal; Prudente, Alessandro; D'Ancona, Carlos A.
  • Reis, Leonardo O; University of Campinas. School of Medicine. Division of Urology. Campinas. BR
  • Barreiro, Guilherme C; University of Campinas. School of Medicine. Division of Urology. Campinas. BR
  • Baracat, Jamal; University of Campinas. School of Medicine. Division of Urology. Campinas. BR
  • Prudente, Alessandro; University of Campinas. School of Medicine. Division of Urology. Campinas. BR
  • D'Ancona, Carlos A; University of Campinas. School of Medicine. Division of Urology. Campinas. BR
Int. braz. j. urol ; 34(5): 627-637, Sept.-Oct. 2008. ilus, graf, tab
Article in English | LILACS | ID: lil-500399
ABSTRACT

OBJECTIVE:

Pressure-flow study is the gold standard for diagnosis of bladder outlet obstruction (BOO). A prospective study was carried out to compare urodynamic evaluation and measurement of intravesical protrusion of the prostate for diagnosing BOO. MATERIALS AND

METHODS:

Patients presenting with lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia and suspected BOO were prospectively evaluated through conventional urodynamics and classified according to the bladder outlet obstruction index (BOOI). They also underwent abdominal ultrasound measurement of the intravesical prostatic protrusion (IPP) and prostatic volume. The IPP was classified into three stages grade I under 5 mm; grade II, between 5 and 10 mm; and grade III over 10 mm.

RESULTS:

Forty-two patients, mean age 64.8 ± 8.5 years were enrolled. Transabdominal ultrasound determined a mean prostatic volume of 45 ± 3.2 mL. Achieved IPP's values were the following grade I - 12 (28.5 percent), grade II - 5 - (12 percent) and grade III - 25 (59.5 percent). The results of prostate volume differed significantly between obstructed and non-obstructed men (p = 0.033) and for IPP among obstructed, inconclusive and non-obstructed men (p = 0.016). For IPP, the area under ROC curve was 0.758 (95 percent confidence interval - 0.601 to 0.876), and the cutoff point to indicate BOO was 5 mm with 95 percent sensitivity (75.1 - 99.2) and 50 percent specificity (28.2 - 71.8).

CONCLUSION:

IPP and prostatic volume measured through abdominal ultrasound are noninvasive and accessible methods that significantly correlate to urinary BOO, and are useful in the diagnosis of male urinary obstructive problems.
Subject(s)

Full text: Available Index: LILACS (Americas) Main subject: Prostatic Hyperplasia / Urinary Bladder Neck Obstruction Type of study: Diagnostic study / Etiology study / Observational study / Prognostic study / Risk factors Limits: Aged / Humans / Male Language: English Journal: Int. braz. j. urol Journal subject: Urology Year: 2008 Type: Article Affiliation country: Brazil Institution/Affiliation country: University of Campinas/BR

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Full text: Available Index: LILACS (Americas) Main subject: Prostatic Hyperplasia / Urinary Bladder Neck Obstruction Type of study: Diagnostic study / Etiology study / Observational study / Prognostic study / Risk factors Limits: Aged / Humans / Male Language: English Journal: Int. braz. j. urol Journal subject: Urology Year: 2008 Type: Article Affiliation country: Brazil Institution/Affiliation country: University of Campinas/BR