Comparasion Between Maximum Watts Factor And Bladder Contractility Index In Prediction Of Postoperative Outcomes In Patients With Benigh Prostate Hyperlapsia

Purpose: Although maximum watts factor(WFmax)and bladder contractility index(BCI)both were reportedly considered as gauges of bladder detrusor contractility,which one more accurately describing the map of postoperative effect of transurethral resection of prostate(TURP)in patients with prostate benign hyperplasia(BPH)was not proved.Clinical data and urodynamic parameters of BPH patients treated with TURP were collected and analyzed to clarify the propriety of predicting postoperative outcomes between WFmax and BCI.Method: Data on age,total prostate specific antigen(TPSA),free prostate specific antigen(F-PSA),international prostate symptoms score(IPSS),quality of life(QOL)prostate volume(PV),Intra-vesical Prostatic Protrusion(IPP),Intra-vesical Prostatic Protrusion Volume(IPPV),detrusor pressure at maximum flow rate(Pdet Qmax),WFmax,BCI,curvature,footpoint,pre-and postoperative maximum flow rate(Qmax)and post-void residual(PVR)of 100 BPH patients treated with TURP from 2015 to 2017 were collected.100 Patients were divided into 4 groups.very weak(WFmax≤5,or BCI≤50),relative weak(5<WFmax≤10,or 50<BCI≤100),relative normal(10<WFmax≤15,or 100<BCI≤150)and relative strong(WFmax>15,or BCI>150).The correlation between parameters and WFmax and BCI were analyzed,and the pre-and postoperative differences of these parameters,including IPSS,QOL,Qmax and PVR,were compared in intra-and inter-groups respectively,and Receiver Operating Characteristic(ROC)curves were drew and the areas under the curve were confirmed.Given ROC curve of WFmax and BCI,the Yoden index,sensitivity and specificity of both were compared.Result: No correlations between age,IPSS,TPSA,FPSA,IPP,IPPV,curvature and WFmax and BCI found,whereas Qmax,Pdet Qmax,and footpoint are positively correlated with WFmax and BCI and PVR is negatively correlated with both.Significant decreasing of IPSS,PVR and increasing of Qmax compared to preoperative values at the postoperative assessment in all intra-groups.No difference found in inter-WFmax groups in term of the improvement extent of pre-compared with postoperative IPSS and Qmax,whereas more significant improvement of postoperative PVR compared with preoperative detected in WFmax group of very weak compared to others(P<0.01).Similar findings in inter-BCI groups compared with WFmax,but the improvement of pre-and postoperative PVR in inter-BCI groups was marginally less than WFmax.ROC analysis showed that(1)WFmax was 8.15 with Yoden index of 0.574,sensitivity of 78.5% and specificity of 78.9%,BCI was 80.35 with Yoden index of 0.458,sensitivity of 75.9 % and specificity of 69.9% in term of postoperative PVR,and both WFmax and BCI did not predict the extent of improvement extent of postoperative Qmax and IPSS compared to preoperative.Conclusion: Regardless of preoperative detrusor contractility,the postoperative symptoms and urodynamic parameters are significantly improved compared with preoperative values.Both WFmax and BCI are the representatives of detrusor contraction and related with PVR,but not Qmax and IPSS,meanwhile WFmax is superior to BCI in prediction of postoperative outcomes,such as PVR,after TURP.