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Age related urodynamic changes in patients with benign prostatic hyperplasia
S Madersbacher1, H C Klingler, G Schatzl
1Department of Urology, University of Vienna, Austria.
The Journal of Urology
|November 1, 1996
Summary
Age significantly impacts urodynamic function in men with benign prostatic hyperplasia (BPH). Maximum flow rate and voided volume decrease with age, while bladder instability increases, highlighting the need for pressure-flow studies before surgery.
Area of Science:
- Urology
- Gerontology
- Medical Science
Background:
- Benign prostatic hyperplasia (BPH) is a common condition in aging men.
- Symptomatic BPH can significantly impact quality of life.
- Understanding age-related changes in urodynamics is crucial for effective management.
Purpose of the Study:
- To investigate age-related urodynamic alterations in men with untreated symptomatic BPH.
- To correlate age with specific urodynamic parameters and International Prostate Symptom Score (I-PSS).
Main Methods:
- A prospective study included 222 men with symptomatic BPH (mean age 67.3 years).
- Evaluated parameters included I-PSS, prostate volume, uroflowmetry, residual volume, and pressure-flow studies.
- Eligibility criteria ensured a homogeneous group with reduced maximum flow rate and significant symptoms.
Main Results:
- No correlation was found between age and I-PSS.
- A significant age-related decrease in maximum flow rate (p=0.045) and voided volume (p=0.0013) was observed.
- Prostate volume increased with age (p<0.0001), while bladder capacity decreased (p=0.0003).
- Bladder instability incidence rose from 20% in younger men to 47% in older men (>80 years).
Conclusions:
- Age-related declines in flow rate and voided volume are not due to increased obstruction or detrusor dysfunction.
- A significant proportion of older men (>80 years) with reduced flow rates lack urodynamic obstruction.
- Pressure-flow studies are recommended for all symptomatic BPH patients with bothersome symptoms justifying surgery, especially those with reduced flow rates, to guide treatment decisions.