A Preliminary Study On The Correlation Between Ultrasound Morphological Indicators And The Severity Of Bladder Outlet Obstruction

Background:Lower urinary tract symptoms(LUTS)is a common disease,among which benign prostatic hyperplasia(BPH)is one of the most common causes of LUTS.Urodynamic examination is the gold standard for diagnosing bladder outlet obstruction(BOO),but it is invasive and not suitable for large-scale application.Therefore,exploring the diagnostic and predictive value of non-invasive ultrasound indicators for BOO is of great significance.Objective:This study aims to explore the diagnostic and predictive value of non-invasive ultrasound indicators for BOO in BPH patients,and analyze their correlation with urodynamic diagnosis of BOO.Methods:Patients who met the inclusion and exclusion criteria were selected for symptom scoring,urodynamic examination,ultrasound examination,etc.According to the calculation formula of BOOI,the patients were divided into BOO group and non-BOO group.ROC curve was used to analyze AUC and CUT-OFF value.Linear test,multicollinearity test,and Spearman correlation analysis were performed after converting continuous variables into binary variables.Logistic regression analysis was used to establish regression equation formula.Results:1、According to the BOOI formula of urodynamic examination,patients with BOOI value greater than or equal to 40 were selected into the BOO group,otherwise into the non-BOO group.A total of 94 patients were selected into the BOO group and31 into the non-BOO group in this study.2、There was a positive correlation between the degree of BOO obstruction and bladder neck anterior lip length,bladder neck posterior lip length,prostatic urethral linear distance(PULD),prostate urethra length(PUL),prostate anterior-posterior diameter length,prostate superior-inferior diameter length,prostate left-right diameter length,prostate volume and intravesical prostatic protrusion(IPP).3 、 ROC curve was used to obtain the AUC value of each indicator,and the indicators were ranked from highest to lowest as follows: PULD(AUC=0.772),prostate volume(AUC=0.719),PUL(AUC=0.741),prostate anterior-posterior diameter length(AUC=0.688),prostate superior-inferior diameter length(AUC=0.673),IPP(AUC=0.65),bladder neck posterior lip length(AUC=0.658).The critical value of PULD was 45.35 mm,with a sensitivity of 76.6% and a specificity of74.2%.The critical value of prostate volume was 56.5mm,with a sensitivity of 58.5%and a specificity of 83.9%.Finally,the critical value of PUL was 56.6mm,with a sensitivity of 52.1% and a specificity of 90.3%.4、The results of multiple logistic regression analysis showed that PULD,AP,and IPP were the predictive factors of BOOI.The fitting equation was logit(P)=-1.153+1.512PULD+1.105AP+1.064 IPP,and the corresponding OR values of PULD,AP,and IPP were 4.534,3.020,and 2.899,respectively.The predicted values analyzed by Hosmer-Lemeshow test and contingency table were close to the actual values,and the fitting degree was good.Conclusion:This study found that non-invasive ultrasound indicators can effectively diagnose and predict BOO in BPH patients,among which PULD,prostate volume,PUL,AP,and IPP are indicators with high diagnostic value.The fitting equation logit(P)=-1.153+1.512PULD+1.105AP+1.064 IPP can be used to predict bladder outlet obstruction.These findings provide new ideas and methods for the diagnosis and treatment of BPH patients.