對於男性下泌尿道症候群病人用攝護腺膀胱內突出度
評估膀胱過動症是可靠的評估因子嗎?
蔡佳宏1、沈元琦1、李偉嘉1、王弘仁1、莊燿吉1
高雄長庚紀念醫院 泌尿科1
Is intravesical prostatic protrusion (IPP) a reliable predictor of overactive bladder in male patients with lower urinary tract symptoms (LUTS) ?
Chia-Hung Tsai1, Yuan-Chi Shen1, Wei-Chia Lee1, Hung-Jen Wang1, Yao-Chi Chuang1
Department of Urology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan1
Purpose: Intravesical prostatic protrusion (IPP) has been suggested as a non-invasive modality for the assessment of bladder outlet obstruction (BOO) in men. BOO is often accompanied by overactive bladder (OAB). We evaluated the association of IPP and OAB.
Materials and Methods: This was an open-labeled, single-center study involving 128 men older than 50 years presenting with lower urinary tract symptoms (LUTS). We analyzed the relationship of IPP with age, prostate volume, uroflowmetry, postvoid residual urine volume (PVR), International Prostate Symptom Score (IPSS), OAB symptom score (OABSS), and urgency severity scale (USS). IPP was measured in the mid sagittal section using transrectal ultrasound. The degree of protrusion was classified as grades 1—5 mm or less, 2—greater than 5 to 10 mm and 3—greater than 10 mm. In the present study, the patients with an urgency score of ≥2 (OABSS question 2) and sum score of ≥3 were considered to have OAB.
Results: The mean age of the patients was 64.86±9.15 years, and 101 patients were diagnosed with OAB (79%). Mean IPPs were 2.4±1.4 mm (grade 1, n=77), 7.6±1.4 mm (grade 2, n=27), and 14.8±4.3 mm (grade 3, n=24). IPP was positively correlated with age (r = 0.18, p <0.05), prostate size (r = 0.58, p <0.001), PSA (r = 0.45, p <0.001), PVR (r = 0.27, p <0.05), IPSS nocturia subscore (r = 0.28, p <0.05), and OABSS nocturia subscore (r = 0.26, p <0.05). IPP was not correlative with the presence of OAB (r = 0.15, p= 0.0969) and degree of OAB. IPP was negatively correlated with Qmax (r = -0.29, p <0.001).
Conclusions: IPP is not a good predictor of OAB in men with LUTS. High grade of IPP might worsen the symptoms of nocturia.