Direct Recording of Urethral Resistance Using the “Urethroresistance”

Abstract

Observations on urethral resistance during micturition in non-obstructed men and in patients with bladder outlet obstruction owing to benign prostatic hypertrophy are presented. The "Urethroresistance", a new instrument, was used for the direct recording of urethral resistance. The upper limit for the minimum urethral resistance during micturition for normal non-obstructed men was 0.5 units. Two patterns of urethral resistance were observed solely in non-obstructed subjects and 3 other patterns, which were found solely in patients with a moderate or severe degree of bladder outlet obstruction, were shown to be characteristic of bladder outlet obstruction. While direct recording of urethral resistance is a better test for bladder outlet obstruction than the recording of urinary flow rate the recording of urinary flow is a simple urodynamic test, which remains a useful screening test for bladder outlet obstruction. With the exception of severe obstructive symptoms none of the other clinical methods for the assessment of bladder outlet obstruction--the size of the prostate gland, the volume of post-micturition residual urine and the degree of bladder trabeculation--is reliable to determine the degree of bladder outlet obstruction.

Role of alpha-adrenergic blockers in the treatment of benign prostatic hyperplasia

“…Relaxation of the prostate smooth muscle should relieve infravesical obstruction in those men with primarily dynamic obstruction. Although the degree of prostatic enlargement is not directly related to severity of obstruction [3,4], shrinkage of the prostate should relieve infravesical obstruction in those men with primarily static obstruction.…”

Percentage area density of epithelial and mesenchymal components in benign prostatic hyperplasia: comparison of results between single biopsy, multiple biopsies and multiple tissue specimens

“…However, all urologists are aware of the paradox of the patient with a small prostate gland and severe obstruction compared with the man with a large prostate gland and no obstructive voiding symptoms [3]. The severity of clinical BPH is not related to the size of the prostatic adenoma [4,5], and the specific features predisposing to Accepted for publication 12 November 1994 the development of bladder outlet obstruction are unknown. A prostatic adenoma is usually formed by two lateral lobes, while in some cases a median lobe is perceptible.…”

“…Immunohisto chemistry using anti-actin as a label of smooth muscle and specific histological staining coupled with computer-assisted quantitative morphometric analysis was used to ascertain the histological composition of the prostate. Results The mean (kSD) area densities obtained from tissue specimens were 34.1 _+ 5%, 32.4_+6.9%, I 7.6 If: 4.5% and 15.9 i -5.5% of smooth muscular and fibrous tissue, and epithelium and glandular lumen, respectively. The mean ratio of stromal to epithelial hyperplasia averaged 4.05k1.73.…”

Quantitative Topographic Distribution of Epithelial and Mesenchymal Components in Benign Prostatic Hypertrophy

“…priate than 'prostatic adenoma'. The severity of clinical BPH is not related to the size of the adenoma [2,3], and its specific features predisposing to the development of bladder outlet obstruction are unknown.Previous studies have been performed to quantitate morphological data of the various components of BPH nodules [4][5][6][7], and a significant increase in stromal tissue has been demonstrated compared to normal prostatic tis-! sue.…”