Predictive value of low maximum flow rate in benign prostatic hyperplasia.

Area of Science:

• Urology
• Medical Science

Background:

• Prostatism affects many men, often necessitating surgical intervention like transurethral resection of the prostate (TURP).
• Uroflowmetry is a key diagnostic tool to assess lower urinary tract symptoms (LUTS).
• Maximum flow rate (Qmax) is a critical parameter in uroflowmetry, with values ≤7 ml/sec potentially indicating significant obstruction.

Purpose of the Study:

• To investigate the underlying causes of low maximum flow rates (≤7 ml/sec) in patients with prostatism undergoing TURP.
• To compare the preoperative and postoperative urodynamic findings and symptom scores between patients with low (≤7 ml/sec) and normal (>7 ml/sec) maximum flow rates.

Main Methods:

• A cohort of 84 patients with prostatism undergoing TURP was retrospectively analyzed.
• Patients were divided into two groups based on preoperative maximum flow rate: Group 1 (≤7 ml/sec) and Group 2 (>7 ml/sec).
• Preoperative and postoperative data including age, symptom duration, symptom scores, bladder volume, residual urine, detrusor pressure, urethral resistance, and maximum flow rate were compared between groups.

Main Results:

• No significant preoperative differences were observed between groups in age, symptom duration, symptom scores, bladder volume, residual urine, or detrusor pressure.
• Group 1 patients exhibited significantly lower urethral resistance and bladder volume-independent maximum flow compared to Group 2.
• Postoperatively, Group 1 patients showed significant improvement in symptom scores and urodynamic findings, excluding bladder volume and detrusor pressure at maximum flow. No significant differences in postoperative outcomes were found between the groups.

Conclusions:

• Low maximum flow rates (≤7 ml/sec) in prostatism patients undergoing TURP are primarily associated with high urethral resistance, not detrusor decompensation.
• Patients with preoperative maximum flow rates ≤7 ml/sec achieve comparable postoperative symptom relief and urodynamic improvements as those with higher flow rates.