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[Determination of infravesical obstruction in men with benign prostatic hyperplasia using pressure-flow measurement
1Urologická klinika Jeseniovej lekárskej fakulty Univerzity Komenského v Martine, Slovakia. svihra@sco.medicalh.sk
Background:
Quantification of infravesical obstruction is important in the management of clinical benign prostatic hyperplasia (BPH).
Objectives:
The assessment of obstruction degree according to the urethral resistance parameter (URA) and bladder contractility (W) with software Dx/CLIM.
Methods:
The study retrospectively analysed a group of 61 patients with BPH in order to assess the degree of obstruction and bladder contractility. Each of the patients underwent pressure/flow studies with Dx/CLIM analysis (URA < 29 cm H2O-unobstructed, Wmax > 12.8 W/m2-normal bladder contractility) and symptom score evaluation (maximum 15 points). In a dose-finding, placebo-controlled study 12 patients received 2 mg of doxazosin (alpha-1 blocker) and 11 patients received placebo during 4 weeks of treatment.
Results:
15 patients were unobstructed (25%) out of whom 10 had poor bladder contractility. Obstruction was present in 46 patients (75%) out of whom 18 had impaired contractility. During treatment, the symptom score decreased statistically significantly in both groups (p < 0.05). URA decreased significantly only in the 2 mg group (2 mg group: baseline URA = 53.9, final mean URA = 40.1, p < 0.05; placebo group: baseline URA = 52.9, final mean URA = 56.1). Detrusor contractility was not significantly affected.
Conclusions:
Pressure/flow studies with Dx/CLIM analysis are very useful in the selection of BPH patients for treatment modalities and in the assessment of efficacy. Doxazosín decreases urethral resistance effectively. (Tab. 3, Fig. 3, Ref. 12.)