The Clinical Value Of Non-invasive Indicators In The Diagnosis Of Bladder Outlet Obstruction

Objective:To study the correlation between non-invasive indexes and bladder outlet obstruction.Methods:138 patients with benign prostatic hyperplasia who came to the Department of Urology at the Affiliated Hospital of Qing Hai University from November 2019 to December 2020 was collected.The patients’age,duration of medical history,International Prostate Symptom Score（IPSS）,serum prostate specific antigen（PSA）and prostate diameter measured by transabdominal ultrasound were collected Superior and inferior diameter of prostate（L）,Anteroposterior diameter of prostate（T）,Transverse diameter of prostate（W）,IPP,PVR and Q_max.All patients were examined by urodynamics,prostate volume（PV）was calculated,according to the size of three diameters of color Doppler ultrasound.According to the standard formula,BOOI=Pdet Q_max-2*Q_max.The bladder outlet obstruction index（BOOI）was calculated.They were divided into two groups according to BOOI,obstructive group:BOOI>40,non obstructive group:BOOI<40.The non-invasive index parameters of patients’age,duration of medical history,IPSS,IPP,prostate volume related parameters,Q_max,PSA and PVR were compared between the two groups.Analyze the correlation between various non-invasive indexes and bladder outlet obstruction between the two groups,establish the receiver operating characteristic curve（ROC curve）to evaluate the value of each non-invasive index in predicting the severity of bladder outlet obstruction.Results:1.There were 138 cases in this study,91 cases in the obstruction group and 47 cases in the non obstruction group.There were no significant differences in patients’age,duration of medical history,PSA and IPSS between the two groups（P>0.05）,but there were significant differences in PV,Superior and inferior diameter of prostate,Anteroposterior diameter of prostate,Transverse diameter of prostate,IPP,Q_max and PVR（P<0.05）.2.Spearman correlation analysis showed that PSA and IPSS had no significant difference with bladder outlet obstruction,but PV,Superior and inferior diameter of prostate,Anteroposterior diameter of prostate,Transverse diameter of prostate,IPP and PVR were positively correlated with the degree of bladder outlet obstruction（P<0.05）,Q_maxwas negatively correlated with the degree of bladder outlet obstruction（P<0.05）;3.The AUC value of the area under the ROC curve of IPP was 0.903（95%CI:0.851～0.955,p<0.05）,the AUC value was the largest among all indexes,and the predictive value was the highest.Secondly,AUC of area under ROC curve of Q_max was 0.799（95%CI:0.715～0.883,p<0.05）,AUC of area under ROC curve of PV was 0.730（95%CI:0.634～0.826,p<0.05）,AUC of area under ROC curve of transverse diameter of prostate was 0.738（95%CI:0.639～0.838,p<0.05）,It shows that Q_max,PV and transverse diameter of prostate volume have moderate predictive value,but PSA,IPSS,Superior and inferior diameter of prostate,Anteroposterior diameter of prostate and PVR have weak predictive effect and have no obvious value in predicting the degree of bladder outlet obstruction.Conclusion:IPP has a high clinical value in predicting and diagnosing the degree of bladder outlet obstruction.The value of Q_max,transverse diameter of prostate and prostate volume in predicting bladder outlet obstruction is also second only to IPP.Although it cannot completely replace urodynamic examination in clinical practice,it can be combined clinically and can be used in patients who cannot or refuse to perform urodynamic examination.An auxiliary supplementary inspection method at the time.