Limits...
Assessment of noninvasive predictors of bladder outlet obstruction and acute urinary retention secondary to benign prostatic enlargement.

Abdel-Aal A, El-Karamany T, Al-Adl AM, Abdel-Wahab O, Farouk H - Arab J Urol (2011)

Bottom Line: Between patients with and without AUR, there was a highly significant difference in IPP, DWT and PSA; a combined IPP threshold of >8 mm and DWT >2 mm detected AUR in 45 of 50 patients (90%).All four noninvasive indices were correlated significantly with BOOI.The IPP as a single variable and combined with DWT predicted BOO and AUR better than PSA or PV.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Benha Faculty of Medicine, Egypt.

ABSTRACT

Purpose: To prospectively compare the diagnostic accuracy of intravesical prostatic protrusion (IPP), detrusor wall thickness (DWT), prostate volume (PV) and serum prostate specific antigen (PSA) levels for detecting bladder outlet obstruction (BOO) and predicting acute urinary retention (AUR) secondary to benign prostatic obstruction.

Patients and methods: In all, 135 men who presented with lower urinary tract symptoms due to benign prostatic enlargement were enrolled in the study; among them, 50 presented with AUR. Thirty normal men in the same age group were included and represented a control group for normative data. Their evaluation included a digital rectal examination, International Prostate Symptom Score and quality-of-life question, uroflowmetry and serum total PSA assay. Transabdominal ultrasonography was used to measure the PV, IPP DWT and post-void residual urine volume. Pressure-flow urodynamic studies were used as the reference standard test for BOO, differentiating obstructed from unobstructed bladders. DWT, IPP, PV and total PSA level served as index tests. To compare the usefulness of the various indices, the area under the curve (AUC) of receiver-operator characteristic curves was calculated for each index.

Results: According to presentation and urodynamic studies, patients were classified into three groups: Group 1 (no BOO), 50 patients with a BOO index (BOOI) of <40; group 2 (BOO), 35 with a BOOI of >40; and group 3 (AUR), 50 who presented with AUR. The IPP, DWT, PV and PSA levels differed significantly between obstructed and unobstructed patients, with a significant correlation with the BOOI. The AUC for IPP, DWT, PSA and PV were 0.885, 0.783, 0.745 and 0.678, respectively. The IPP threshold at 8 mm provided the best diagnostic accuracy (80%) for detecting BOO, followed by combined DWT and IPP (77.6%). Between patients with and without AUR, there was a highly significant difference in IPP, DWT and PSA; a combined IPP threshold of >8 mm and DWT >2 mm detected AUR in 45 of 50 patients (90%).

Conclusion: All four noninvasive indices were correlated significantly with BOOI. The IPP as a single variable and combined with DWT predicted BOO and AUR better than PSA or PV.

No MeSH data available.


Related in: MedlinePlus

Measurements made to compute the DWT.
© Copyright Policy - CC BY-NC-ND
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4150574&req=5

f0010: Measurements made to compute the DWT.

Mentions: DWT was measured using the 7.5-MHz linear probe in the horizontal direction at maximum magnification, when the bladder volume was ≈200 mL, by natural filling in patients without retention, or by infusion through the indwelling catheter in patients with AUR (Fig. 2). The outer and inner detrusor muscle surfaces were identified by hyperechogenic lines corresponding to subserosal tissue and to bladder mucosa plus submucosal tissue, respectively. The hypoechogenic layer in between corresponding to the detrusor wall was measured at three points of the anterior bladder wall, 1 cm apart, and a mean value was recorded for further calculation [5].


Assessment of noninvasive predictors of bladder outlet obstruction and acute urinary retention secondary to benign prostatic enlargement.

Abdel-Aal A, El-Karamany T, Al-Adl AM, Abdel-Wahab O, Farouk H - Arab J Urol (2011)

Measurements made to compute the DWT.
© Copyright Policy - CC BY-NC-ND
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4150574&req=5

f0010: Measurements made to compute the DWT.
Mentions: DWT was measured using the 7.5-MHz linear probe in the horizontal direction at maximum magnification, when the bladder volume was ≈200 mL, by natural filling in patients without retention, or by infusion through the indwelling catheter in patients with AUR (Fig. 2). The outer and inner detrusor muscle surfaces were identified by hyperechogenic lines corresponding to subserosal tissue and to bladder mucosa plus submucosal tissue, respectively. The hypoechogenic layer in between corresponding to the detrusor wall was measured at three points of the anterior bladder wall, 1 cm apart, and a mean value was recorded for further calculation [5].

Bottom Line: Between patients with and without AUR, there was a highly significant difference in IPP, DWT and PSA; a combined IPP threshold of >8 mm and DWT >2 mm detected AUR in 45 of 50 patients (90%).All four noninvasive indices were correlated significantly with BOOI.The IPP as a single variable and combined with DWT predicted BOO and AUR better than PSA or PV.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Benha Faculty of Medicine, Egypt.

ABSTRACT

Purpose: To prospectively compare the diagnostic accuracy of intravesical prostatic protrusion (IPP), detrusor wall thickness (DWT), prostate volume (PV) and serum prostate specific antigen (PSA) levels for detecting bladder outlet obstruction (BOO) and predicting acute urinary retention (AUR) secondary to benign prostatic obstruction.

Patients and methods: In all, 135 men who presented with lower urinary tract symptoms due to benign prostatic enlargement were enrolled in the study; among them, 50 presented with AUR. Thirty normal men in the same age group were included and represented a control group for normative data. Their evaluation included a digital rectal examination, International Prostate Symptom Score and quality-of-life question, uroflowmetry and serum total PSA assay. Transabdominal ultrasonography was used to measure the PV, IPP DWT and post-void residual urine volume. Pressure-flow urodynamic studies were used as the reference standard test for BOO, differentiating obstructed from unobstructed bladders. DWT, IPP, PV and total PSA level served as index tests. To compare the usefulness of the various indices, the area under the curve (AUC) of receiver-operator characteristic curves was calculated for each index.

Results: According to presentation and urodynamic studies, patients were classified into three groups: Group 1 (no BOO), 50 patients with a BOO index (BOOI) of <40; group 2 (BOO), 35 with a BOOI of >40; and group 3 (AUR), 50 who presented with AUR. The IPP, DWT, PV and PSA levels differed significantly between obstructed and unobstructed patients, with a significant correlation with the BOOI. The AUC for IPP, DWT, PSA and PV were 0.885, 0.783, 0.745 and 0.678, respectively. The IPP threshold at 8 mm provided the best diagnostic accuracy (80%) for detecting BOO, followed by combined DWT and IPP (77.6%). Between patients with and without AUR, there was a highly significant difference in IPP, DWT and PSA; a combined IPP threshold of >8 mm and DWT >2 mm detected AUR in 45 of 50 patients (90%).

Conclusion: All four noninvasive indices were correlated significantly with BOOI. The IPP as a single variable and combined with DWT predicted BOO and AUR better than PSA or PV.

No MeSH data available.


Related in: MedlinePlus