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Supraspinal Neural Changes in Men With Benign Prostatic Hyperplasia Undergoing Bladder Outlet Procedures: A Pilot
Logan C Hubbard1, Zhaoyue Shi2, Ricardo R Gonzalez1
1Department of Urology, Houston Methodist Hospital, Houston, TX.
Urology
|July 21, 2022
Summary
This pilot study explored brain activity in men with benign prostatic hyperplasia (BPH) and bladder outlet obstruction (BOO). Findings show changes in brain regions like the insula and IFG after surgery, suggesting neuroplasticity.
Area of Science:
- Neuroscience
- Urology
- Radiology
Background:
- Benign prostatic hyperplasia (BPH) and bladder outlet obstruction (BOO) significantly impact men's quality of life.
- Understanding the neurological underpinnings of BPH/BOO is crucial for developing effective treatments.
Purpose of the Study:
- To investigate brain activation patterns using functional MRI (fMRI) in men with BPH and BOO.
- To compare fMRI findings before and after surgical procedures to relieve outlet obstruction.
Main Methods:
- Recruited men aged ≥45 with BPH/BOO undergoing outlet obstruction procedures.
- Conducted concurrent fMRI and urodynamics testing pre- and 6 months post-procedure.
- Analyzed blood-oxygen-level-dependent (BOLD) signal changes during voiding phases.
Main Results:
- Observed decreased BOLD activity in the right inferior frontal gyrus (IFG), bilateral insula, and thalamus at baseline.
- Detected significant changes in BOLD signal activity in the insula, IFG, and cingulate cortices post-procedure.
- Eleven men were enrolled; 7 completed baseline scans, and 4 completed follow-up.
Conclusions:
- This pilot study highlights changes in supraspinal activity related to BPH and BOO.
- Findings suggest potential neuroplasticity in response to outlet obstruction and its relief.
- Preliminary data may inform larger future clinical trials.
