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| Patients with small prostates and low-grade intravesical prostatic protrusion——A urodynamic evaluation |
| Han Jie Lee, Alvin Lee, Hong Hong Huang, Palaniappan Sundaram, Keong Tatt Foo
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| Department of Urology, Singapore General Hospital, Singapore |
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Abstract Objective: Despite high-grade intravesical prostatic protrusion (IPP) being closely related to bladder outlet obstruction (BOO), up to 21% of patients with low IPP remain obstructed. This study evaluates the characteristics and urodynamic findings of men with small prostates and low IPP.
Methods: One hundred and fourteen men aged >50 years old with lower urinary tract symptoms (LUTS) were assessed with symptoms, uroflowmetry, serum prostate-specific antigen (PSA), transabdominal ultrasound measurement of prostate volume (PV), IPP and post-void residual urine (PVRU). All patients underwent pressure flow studies. Patients with PV < 30 mL and IPP ≤ 10 mm were examined for parameters correlating with BOO or impaired detrusor contractility.
Results: Thirty-six patients had PV < 30 mL and IPP < 10 mm. Nine patients (25.0%) had urodynamic BOO, all with normal bladder contractility. Fourteen patients (38.9%) had poor detrusor contractility and all had no BOO. PV, PVRU and IPP were significantly associated with BOO, with IPP showing greatest positive correlation. Both Qmax and IPP were significantly associated with detrusor contractility. At 5-year follow-up, most patients responded to medical therapy. Only three out of nine patients (33.3%) with BOO eventually underwent surgery, and all had a high bladder neck seen on the resectoscope. Only one patient (7.1%) with poor detrusor contractility eventually required surgery after repeat pressure flow study revealed BOO.
Conclusion: In men with small prostates and low IPP, the presence of BOO is associated with higher PV, PVRU and IPP, and most respond well to medical management. BOO can possibly be explained by elevation of the bladder neck by a small subcervical adenoma.
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Published: 26 October 2017
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| [1] |
S. Sfanos Karen,Yegnasubramanian Srinivasan,G. Nelson William,L. Lotan Tamara,Kulac Ibrahim,L. Hicks Jessica,Zheng Qizhi,J. Bieberich Charles,C. Haffner Michael,M. De Marzo Angelo. If this is true, what does it imply? How end-user antibody validation facilitates insights into biology and disease[J]. Asian Journal of Urology, 2019, 6(1): 10-25. |
| [2] |
Zhao Pei,Zhu Yezi,Cheng Liang,Luo Jun. Detection of androgen receptor (AR) and AR-V7 in small cell prostate carcinoma: Diagnostic and therapeutic implications[J]. Asian Journal of Urology, 2019, 6(1): 109-113. |
| [3] |
Dong Liang,C. Zieren Richard,Xue Wei,M. de Reijke Theo,J. Pienta Kenneth. Metastatic prostate cancer remains incurable, why?[J]. Asian Journal of Urology, 2019, 6(1): 26-41. |
| [4] |
M. Armstrong Cameron,C. Gao Allen. Current strategies for targeting the activity of androgen receptor variants[J]. Asian Journal of Urology, 2019, 6(1): 42-49. |
| [5] |
B. Isaacs William,Xu Jianfeng. Current progress and questions in germline genetics of prostate cancer[J]. Asian Journal of Urology, 2019, 6(1): 3-9. |
| [6] |
Etheridge Tyler,Damodaran Shivashankar,Schultz Adam,A. Richards Kyle,Gawdzik Joseph,Yang Bing,Cryns Vincent,F. Jarrard David. Combination therapy with androgen deprivation for hormone sensitive prostate cancer: A new frontier[J]. Asian Journal of Urology, 2019, 6(1): 57-64. |
| [7] |
Chia-Yi Chu Gina,W.K. Chung Leland,Gururajan Murali,Hsieh Chia-Ling,Josson Sajni,Nandana Srinivas,Sung Shian-Ying,Wang Ruoxiang,Boyang Wu Jason,E. Zhau Haiyen. Regulatory signaling network in the tumor microenvironment of prostate cancer bone and visceral organ metastases and the development of novel therapeutics[J]. Asian Journal of Urology, 2019, 6(1): 65-81. |
| [8] |
Dicken Haley,J. Hensley Patrick,Kyprianou Natasha. Prostate tumor neuroendocrine differentiation via EMT: The road less traveled[J]. Asian Journal of Urology, 2019, 6(1): 82-90. |
| [9] |
Xu Lingfan,Chen Junyi,Liu Weipeng,Liang Chaozhao,Hu Hailiang,Huang Jiaoti. Targeting androgen receptor-independent pathways in therapy-resistant prostate cancer[J]. Asian Journal of Urology, 2019, 6(1): 91-98. |
| [10] |
S. Akinboye Emmanuel,Nathaniel Brennen W.,R. Denmeade Samuel,T. Isaacs John. Albumin-linked prostate-specific antigen-activated thapsigargin- and niclosamide-based molecular grenades targeting the microenvironment in metastatic castration-resistant prostate cancer[J]. Asian Journal of Urology, 2019, 6(1): 99-108. |
| [11] |
Chen Kenneth,Jack Tay Kae,Mee Law Yan,Aydin Hakan,Ho Henry,Cheng Christopher,Shyi Peng Yuen John. Outcomes of combination MRI-targeted and transperineal template biopsy in restaging low-risk prostate cancer for active surveillance[J]. Asian Journal of Urology, 2018, 5(3): 184-193. |
| [12] |
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| [13] |
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| [14] |
M.de Vries* Allert,P.F.A.Heesakkers John. Contemporary diagnostics and treatment options for female stress urinary incontinence[J]. Asian Journal of Urology, 2018, 5(3): 141-148. |
| [15] |
Chen Kenneth,Sim Allen,Kan Alex Ford. The effect of adjunct caudal block on postoperative analgesia in robot-assisted laparoscopic radical prostatectomy: A prospective randomized controlled, single blinded pilot study in a tertiary centre[J]. Asian Journal of Urology, 2018, 5(2): 122-126. |
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