Clinical Implications of Residual Urine in Korean Benign Prostatic Hyperplasia (BPH) Patients: A Prognostic Factor for BPH-Related Clinical Events

Abstract

PurposeAlthough post-void residual urine (PVR) is frequently utilized clinically in patients with benign prostatic hyperplasia (BPH), mainly because of its procedural simplicity, its role as a clinical prognostic factor, predictive of treatment goals, is still under much dispute. We investigated the predictive value of PVR for BPH-related clinical events including surgery, acute urinary retention (AUR), and admission following urinary tract infection (UTI).MethodsFrom January to June of 2006, patients over 50 years of age who were diagnosed with BPH for the first time at the outpatient clinic and were then treated for at least 3 years with medications were enrolled in this study. The variables of patients who underwent surgical intervention for BPH, had occurrences of AUR, or required admission due to UTI (Group 1, n=43) were compared with those of patients who were maintained with medications only (Group 2, n=266).ResultsGroup 1 had a significantly higher PVR, more severe symptoms, and a larger prostate at the time of the initial diagnosis in both the univariate and the multivariate analysis. In the 39 patients who underwent BPH-related surgery, although there was a significant change in Qmax at the time of surgery (mean, 13.1 months), PVR and the symptom score remained unchanged compared with the initial evaluation. In the receiver-operating characteristic curve analysis, the area under the curve of Group 1 was in the order of prostate volume (0.834), PVR (0.712), and symptom score (0.621). When redivided by arbitrarily selected PVR cutoffs of 50 mL, 100 mL, and 150 mL, the relative risk of clinical BPH progression was measured as 3.93, 2.61, and 2.11.ConclusionsThese data indicate that, in the symptomatic Korean population, increased PVR at baseline is a significant indicator of BPH-related clinical events along with increased symptom score or prostate volume.

Oxidative stress in the bladder of men with LUTS undergoing open prostatectomy: a pilot study

“… MDA = malondialdehyde; SOD = superoxide dismutase; LUTS = lower urinary tract symptoms; SD = standard deviation; BMI = body mass index; IPSS = International Prostate Symptom Score; OAB-V8 = Overactive Bladder-Validated 8-question Screener Questionnaire; IPP = intravesical protrusion of the median prostatic lobe; BCI = bladder contractility index;* n = 38;¥= T test;§“urgency” was defined as “the complaint of a sudden compelling desire to pass urine which is difficult to defer” (18);¶primary endpoint…”

“…§“urgency” was defined as “the complaint of a sudden compelling desire to pass urine which is difficult to defer” (18);…”

“…In our study, PVR was measured by catheterization after free uroflowmetry (before starting the filling cystometry). Increased PVR was arbitrarily defined as a volume ≥ 50 mL (18).…”

Efficacy and Safety of the Sandwich Method in Patients with Benign Prostate Hyperplasia: Bipolar Transurethral Resection with GreenLight Vaporization

“…However, mixed evidence exists regarding the predictive value of PVR as a diagnostic or prognostic test. A possible reason for this may be the wide variation noted among men [ 11 ]. Thus, this might explain the significant difference in postoperative PVR observed between the two groups in this study.…”

Heritability and genome-wide association study of benign prostatic hyperplasia (BPH) in the eMERGE network

“…Lower urinary tract symptoms (LUTS) are commonly attributed to BPH in the absence of other causes 5–7 . Very severe cases can result in urinary tract infections and bleeding, bladder stones, and kidney damage from failing to void 7–10 . Pharmaceutical treatments for BPH include alpha blockers to relax muscles and treat some LUTS symptoms, and 5-alpha reductase inhibitors which can shrink the prostate in some patients but may increase risk for prostate cancer 11–16 .…”