Study On The Correlation Between Improved Bladder Outlet Obstruction Index And Lower Urinary Tract Symptoms And Surgical Results In Benign Prostatic Hyperplasia

Objective:Study on the bladder obstruction index of benign prostatic hyperplasia（BPH）And modified bladder obstruction index（mBOOI）were associated with lower urinary tract symptoms（LUTS）,urodynamic and surgical outcomes.Methods:A total of 146 patients diagnosed with BPH and undergoing transurethral resection of prostate were retrospectively collected from February 2016 to August 2018 in Guizhou Provincial People’s Hospital.The age,prostate volume（PV）and prostate specific antigen（PSA）of all subjects were collected.PSA),the Total International Prostate Symptom Score（IPSS-T）before and after surgery,and the voiding IPSS before and after surgery.IPSS-V),QOL scores before and after surgery,maximum urinary flow rate(Q_max),and post voiding residual,PVR),intravesical pressure,abdominal pressure,and bladder detrusor pressure at maximum urinary flow Rate,P_detQ_max).Bladder obstruction index（BOOI）,mBOOI,IPSS-T difference,IPSS-V difference and QOL difference were calculated,and all subjects were divided into BOO group and no BOO group according to BOOI value and mBOOI value.Age,PV,PSA,P_detQ_max,intra-bladder pressure,abdominal pressure,Q_max,PVR,preoperative IPSS-T,postoperative IPSS-T,IPSS-T difference,preoperative IPSS-V,postoperative IPSS-V,IPSS-V difference,preoperative QOL score,postoperative QOL score and QOL difference were compared between the two groups.mBOOI,BOOI and lower urinary tract symptoms（preoperative IPSS-T,preoperative IPSS-V,preoperative QOL,postoperative IPSS-T,postoperative IPSS-V,postoperative QOL）and urodynamics(P_detQ_max,bladder pressure,Q_max,PVR)were analyzed by Pearson linear correlation and Spearman rank correlation,abdominal pressure),surgical outcomes（IPSS-T difference,IPSS-V difference,QOL difference）,and further compare the differences between mBOOI and BOOI.Results:1.According to the BOOI value,the two groups were divided into BOO group and no BOO group.The differences in P_detQ_max,abdominal pressure,bladder pressure,postoperative IPSS-T,postoperative QOL,IPSS-T difference,IPSS-V difference and QOL difference between the two groups were statistically significant（P<0.05）.However,there were no significant differences in age,PV,PSA,Q_max,PVR,preoperative IPSS-T,preoperative IPSS-V,preoperative QOL and postoperative IPSS-V between groups based on the BOOI value（P>0.05）.2.According to the mBOOI value,the two groups were divided into Bo O group and no BOO group.The differences in P_detQ_max,abdominal pressure,bladder pressure,postoperative IPSS-T difference,IPSS-V difference,postoperative IPSS-T,postoperative QOL and QOL difference between the two groups were statistically significant（P<0.05）.However,there were no significant differences in age,PV,PSA,preoperative IPSS-T,preoperative IPSS-V,preoperative QOL,Q_max,PVR and postoperative IPSS-V between groups based on mBOOI value（P>0.05）.3.Pearson linear correlation or Spearman rank correlation indicated that mBOOI and BOOI were not significantly correlated with patients’age,PV and PSA（P>0.05）.4.Pearson linear correlation or Spearman rank correlation indicated that BOOI was correlated with urodynamic index Q_max（r_s=-0.192,P=0.020）,P_detQ_max（r=0.971,P<0.001）,bladder pressure（r=0.836,P<0.001）,IPSS-T difference（r=0.314,P<0.001）,IPSS-V difference（r=0.246,P=0.003）were correlated;BOOI was not associated with lower urinary tract symptoms（preoperative IPSS-T,preoperative IPSS-V,preoperative QOL）,PVR,abdominal pressure,and QOL difference（P>0.05）.5.Pearson linear correlation or Spearman rank correlation indicated that mBOOI was associated with lower urinary tract symptoms in preoperative IPSS-T（r=0.23,P=0.005）,preoperative IPSS-V（r_s=0.188,P=0.023）,and ureodynamic P_detQ_max（r=0.830,P<0.001）,bladder pressure（r=0.975,P<0.001）,abdominal pressure（r_s=0.467,P=0.024）,Q_max（r_s=-0.187,P=0.024）,IPSS-T difference（r=0.433,P<0.001）,IPSS-V difference（r=0.362,P<0.001）;There was no correlation between preoperative QOL（r_s=0.097,P=0.246）and PVR（r_s=0.026,P=0.755）,QOL difference（r_s=0.155,P=0.062）.Conclusion:1.BOOI was correlated with P_detQ_max,abdominal pressure,bladder pressure,postoperative IPSS-T,postoperative QOL,IPSS-T difference,IPSS-V difference,and QOL difference;mBOOI was correlated with P_detQ_max、abdominal pressure,intravesical pressure,postoperative IPSS-T difference,IPSS-V difference,postoperative IPSS-T、postoperative QOL、QOL difference.2.Both mBOOI and BOOI were close to the urodynamic characteristics of patients;Compared with BOOI,mBOOI is more close to the urodynamic characteristics of patients and can better evaluate the lower urinary tract obstruction and the surgical effect of transurethral resection of prostate in patients with BPH.