Arteriosclerosis related factors had no clinical significant correlation with resistive index in symptomatic benign prostatic hyperplasia.

OBJECTIVE: To investigate whether the resistive index (RI) in symptomatic benign prostatic hyperplasia (BPH) could be used as a surrogate index of the severity of lower urinary tract symptoms (LUTS) due to BPH, and whether arteriosclerosis-related factors were associated with the RI in LUTS due to BPH. METHODS: From January 2005 to April 2008, a total of 625 men with LUTS due to BPH were prospectively enrolled. Patients with heart failure, liver cirrhosis, prostatic cancer, neurogenic bladder, acute prostatitis, acute urinary retention, urethral stenosis, history of transurethral resection or any drug treatment for BPH, or currently under drug treatment for type 2 diabetes mellitus or dyslipidemia were excluded. Variables analyzed included estimated smoking status, blood pressure, body mass index (BMI), serum fasting glucose (FBS), lipid profile (low-density lipoprotein-cholesterol, high density lipoprotein-cholesterol and triglyceride), serum prostate-specific antigen, International Prostatic Symptom Score (IPSS), quality of life score, maximum urinary flow rate (Q(max.)), and postvoid residual urine volume (PVR). We also measured total prostate volume, transition zone (TZ) index, and RI using transrectal ultrasonography. Correlations among parameters were statistically examined. RESULTS: RI was significantly correlated with IPSS, Q(max.), and PVR, but not with blood pressure, BMI, or FBS. On multiple regression analysis, RI was a significant independent variable of IPSS, TZ index, and PVR. CONCLUSIONS: These findings suggest that RI might represent a surrogate index of the severity of LUTS due to BPH, and that RI might have no clinically significant relationship with arteriosclerosis-related factors.

Resistive index as risk factor for acute urinary retention in patients with benign prostatic hyperplasia.

OBJECTIVES: To examine the usefulness of several parameters obtained by transrectal ultrasonography in predicting acute urinary retention (AUR). METHODS: The present study consecutively enrolled 1962 men with a complaint of lower urinary tract symptoms. Of these men, 245 were found to have AUR on examination at our clinic. We assessed the International Prostate Symptom Score (IPSS), maximal urinary flow rate, and postvoid residual urine volume and measured the total prostate volume, transition zone index (TZI), and resistive index (RI) using transrectal ultrasonography. To compare the usefulness of these indexes for predicting AUR, we calculated the area under the receiver operating characteristic curve for each index and for age. RESULTS: In patients without AUR, age, prostate-specific antigen level, IPSS, maximal urinary flow rate, and postvoid residual urine volume were significantly correlated with both the TZI and the RI (P < .001). Multiple regression analysis demonstrated that age, maximal urinary flow rate, postvoid residual urine volume, and TZI were significant independent determinants of the RI (P < .001). Patients with AUR were, on average, older and had an elevated prostate-specific antigen level, increased IPSS, and greater TZI and RI than patients without AUR (P < .001). The area under the receiver operating characteristic curve was 0.640 (95% confidence interval [CI] 0.618-0.662) for age, 0.674 (95% CI 0.653-0.695) for prostate-specific antigen level, 0.787 (95% CI 0.768-0.805) for total prostate volume, 0.821 (95% CI 0.803-0.838) for IPSS, 0.860 (95% CI 0.844-0.875) for TZI, and 0.867 (95% CI 0.851-0.882) for RI. CONCLUSIONS: The RI and TZI obtained using transrectal ultrasonography correlated with the incidence of AUR and are useful predictors of AUR in patients with benign prostatic hyperplasia.

Resistive index: a newly identified predictor of outcome of transurethral prostatectomy in patients with benign prostatic hyperplasia.

OBJECTIVE: To examine the usefulness of several preoperative parameters obtained through transrectal ultrasonography in predicting the outcome of transurethral resection of the prostate (TURP). METHODS: A total of 572 men aged 51-85 years scheduled to undergo TURP for benign prostatic hyperplasia were prospectively enrolled, and 560 were ultimately evaluated. We preoperatively assessed International Prostate Symptom Score (IPSS), quality of life (QOL) score, maximum urinary flow rate (Q(max)), and postvoid residual urine volume (PVR), and measured total prostate volume (TPV), transition zone (TZ) index, and resistive index (RI) using transrectal ultrasonography. To compare the usefulness of the latter 3 indices, we calculated the area under the receiver operating characteristic (ROC) curve for each index and for IPSS. RESULTS: IPSS (total, postmicturition symptoms, storage symptoms, voiding symptoms), QOL score, Q(max), and PVR were significantly improved after TURP. Significant differences between the effective and noneffective groups were observed with regard to age, IPSS (total, postmicturition symptoms, storage symptoms, voiding symptoms), QOL score, TPV, TZ index, RI, Q(max), and PVR. The area under the ROC curve was 0.663 for IPSS, 0.691 for TPV, 0.719 for the TZ index, and 0.845 for the RI. CONCLUSIONS: The RI is a useful predictor of an effective outcome after TURP in patients with benign prostatic hyperplasia and may be useful for determining suitability for surgical intervention.