Correlation Between Functional Obstruction And Urinary Tract Complications Linked To BPH

Background:Bladder outlet obstruction (BOO) is the important pathological basis of benignprostatic hyperplasia (BPH) which is the most common benign disease in males. Now,pressure-uroflow studies (P/Q) as a golden standard for evaluating BOO is widely used inclinical practice. However, many patients can not void because of various factors, such astension and uncomfortable examination, which make urologists fail to get availableoutcomes according to P/Q. Resting urethral pressure profile (RUPP), as a routineurodynamic test, is used to assess urethral function in storage period. This test does notdepend on patients’ voiding behaviors. Therefore, to explore the relationship between theparameters of RUPP and the occurrence of BOO is benefit to evaluate the uretheral functionof BPH patients.Urinary tract complications linked to BPH are important progress of BPH. BOO as theimportant pathological basis of BPH plays a key role in the occurrence of thesecomplications. The diagnosis of these diseases usually depends on patients’ symptoms.However, the symptoms are not unique, and their occurrence frequently lags behind theonset of disease, which could influence the diagnosis and treatments. How to diagnose thesediseases earlier is very important for BPH patients. Therefore, to explore the relationshipsbetween urodynamic parameters and the occurrences of urinary tract complications is veryvaluable for reducing the risk of BPH progress, and also provides more reliable informationfor clinical decision.Objective:1. To explore the value of RUPP parameters in evaluating BOO linked to BPH.2. To assess the correlation between urodynamic parameters and urinary tractcomplications linked to BPH, as well to assess the possible value of these parameters forpredicting complication. Methods:1. We retrospectively analyzed urodynamic and clinical data of119BPH patients,which were divided into three groups according to the outcomes of P/Q. Multivariatestepwise logistic regression and ROC curves were used to evaluate the value of RUPPparameters in assessing BOO due to BPH.2. We retrospectively analyzed the relationship between the complications andcorrelative urodynamic data of486BPH patients, which were grouping according to theoccurrences of different complications. Multivariate stepwise logistic regression was used toidentify major independent predictors and establish regression models. Receiver operatingcharacteristic (ROC) curves were constructed to evaluate the predictive values ofurodynamic parameters and the models.Results:1. Compared to unobstructed group, the following RUPP parameters, such as pressureof bladder neck, pressure of seminal colliculus, prostatic length, functional profile lengthand prostatic plateau area (PPA) were significant higher in obstructed group. According toROC analysis, the combined effects from the logistical regression model and most RUPPparameters had diagnostic value (p<0.05). Meanwhile, the regression model is the bestindicator to assess the occurrence of BOO, and PPA is the best one among individualparameter.2. All of the individual parameters examined significantly correlated with most of thecomplications linked to BPE, except bladder calculus. According to ROC analysis, all of theareas under ROC curves (AUC) comparison of the individual parameters and the combinedeffects from the logistical regression models reached statistical significance (p<0.05), andcombining the parameters revealed a higher AUC compared to the individual parameters;however, all of the AUCs were below0.9.Conclusions:1. RUPP parameters could be used to assess the situation of BOO in BPH patients,which could be considered as a supplementary method for P/Q study. And the regressionmodel is the best indicator among all parameters.2. Urodynamic parameters are significantly correlated with most of the complicationslinked to BPH, and these parameters have predictive value for the occurrence of these complications with limited values.