Bladder and Prostate Sonomorphology as Non Invasive Method for Assessing the Lower Urinary Tract in Patient with Symptomatic Bladder Outlet Obstruction Due to Benign Prostate Enlargement
Iraqi Postgraduate Medical Journal,
2021, Volume 20, Issue 1, Pages 53-57
Measurement of the bladder weight, bladder wall thickness and intravesical prostatic protrusion can be done by using ultrasound which is a simple, non-invasive and less complex, which may predict bladder outlet obstruction in patient with benign prostatic hyperplasia.
PATIENTS AND METHOD:
Across sectional comparative study conducted inUrology outpatient department at Ghazi al-Hariri hospital for surgery specialties during the period between the first of March 2017 till the end of July 2018, a sample of 47 men aged 50 years or older with LUTS/BPH grouped in 2 groups according to urodynamic results: patients with bladder outlet obstruction and patients patient without outlet obstruction.
In this study, we observed that bladder wall thickness, bladder weight and intravesical prostate protrusion were higher in bladder outlet obstruction group as compared to non- bladder outlet obstruction group with significant accuracy, sensitivity and specificity.
Ultrasonographic measurements of bladder wall thickness, ultrasound estimated bladder weight and intravesical prostate protrusion are good parameters for the diagnosis of symptomatic bladder outlet obstruction due to benign enlargement of the prostate and they are easy to measure, with no complications, less time consuming and cost effective.
- Presti JC, Cane CJ, Shinohara K, Carnot PR: Neoplasms of the prostate gland. Smith’s General Urology, 18th Ed. 2013.
- Oelke M, Hofner K, Jonas U et al Diagnostic accuracy of noninvasive tests to evaluate bladder outlet obstruction in men: detrusor wall thickness, uroflowmetry, postvoid residual urine, and prostate volume. Eur Urol2007;52:827-34.
- Arnolds M, Oelke M. invasive versus noninvasive urodynamics in the assessment of bladder outlet obstruction. Curr Opin Urol2009;19:55-62.
- Klingler HC, Madersbacher S, Djavan Bet al. Morbidity of the evaluation of the lower urinary tract with transurethral multichannel pressure-flow studies. J Urol1998;159:191-4.
- Berges R, Oelke M. Age-stratified normal values for prostate volume, PSA, maximum urinary flow rate, IPSS, and other LUTS/BPH indicators in the German male community-dwelling population aged 50 years or older. World J Urol2011;29:171-78.
- Benign prostatic hyperplasia. Urology 2001;58:966e71
- Nitti VW, Kim Y, Combs AJ. Correlation of the AUA symptom index with urodynamics in patients with suspected benign prostatic hyperplasia. Neurourol Urodyn1994;13:521-27.
- Abrams P, Cardozo L, Fall M et al. The standardisation of terminology in lower urinary tract function: report from the standardisation subcommittee of the International Continence Society. Urology2003;61:37-49.
- Abrams P: In support of pressure-flow studies for evaluating men with lower urinary tract symptoms. Urology 1994; 44: 153–5.
10. Giancarlo Vignoli : New Noninvasive Urodynamic Techniques . Urodynamics A Quick Pocket Guide . 2017;75-76.
11. Darab Mehraban: Clinical value of intravesical prostatic protrusion in the evaluation and management of prostatic and other lower urinary tract diseases. Asian Journal of Urology (2017) xx, 1-7.
12. Harris R.A., Follett D.H., Halliwell M., et al.: Ultimate limits in ultrasound imaging resolution. Ultrasound Med. Biol. 1991;17: 547-58.
13. Oelke M, Hofner K, Jonas U, Ubbink D, de la Rosette J, Wijkstra H. Ultrasound measurement of detrusor wall thickness in healthy adults. Neurourol Urodyn 2006;25:308e17.
14. Kojima M., Inui E., Ochiai A., et al.: Ultrasonic estimation of bladder weight as a measure of bladder hypertrophy in men with infravesical obstruction: a preliminary report. Urology.1996;47: 942-47.
15. Guzel O, Aslan Y, Balci M, Tuncel A, Keten T, Erkan A, Atan A. Can Bladder Wall Thickness Measurement Be Used for Detecting Bladder Outlet Obstruction? Urology2015;86:439-44.
16. Manieri C, Carter SS, Romano G, et al. The diagnosis of bladder outlet obstruction in men by ultrasound measurement of bladder wall thickness. J Urol. 1998;159:761–765.
17. Kessler T.M., Gerber R., Burkhard F.C., et al.: Ultrasound assessment of detrusor thickness in men – can it predict bladder outlet obstruction and replace pressure flow study? J. Urol. 2016;175: 2170-2173.
18. Franco G, De Nunzio C, Leonardo C et al. Ultrasound assessment of intravesical prostatic protrusion and detrusor wall thickness–new standards for noninvasive bladder outlet obstruction diagnosis? J Urol 2010; 183: 2270–4.
19. Dicuio M, Pomara G, Vesely S et al.: The use of prostatic intravesical protrution correlated with uroflowmetry: a new method to measure obstruction in patients with LUTS due to BOO without using P/F studies. Arch Ital Urol Androl. 2005; 77: 50-3.
20. Belal M, Abrams P: Noninvasive methods of diagnosing bladder outlet obstruction in men. Part 1: Nonurodynamic approach. J Urol, 2006;176:22-8.
21. Miyashita H, Kojima M, Miki T. Ultrasonic measurement of bladder weight as a possible predictor of acute urinary retention in men with lower urinary tract symptoms suggestive of benign prostatic hyperplasia. Ultrasound Med Biol2002;28:985-90.
22. Nitti VW. Pressure flow urodynamic studies: the gold standard for diagnosing bladder outlet obstruction. Rev Urol 2015;7 Suppl 6:S14-21.
- Article View: 3
- PDF Download: 9