We investigated the possible association between preoperative bladder wall thickness (BWT) or detrusor wall thickness (DWT) and bladder outlet obstruction (BOO) based on urodynamic studies in men with symptomatic benign prostatic hyperplasia (BPH).
Data were prospectively collected from a BPH surgery database. A total of 196 men who underwent prostate vaporization for symptomatic BPH were included in this study. BWT and DWT were measured in the suprapubic area after uroflowmetry.
No significant difference was noted in BWT and DWT in any patient according to the presence of BOO; however, subgroup analysis showed that BWT and DWT were significantly thicker in the obstruction group in men aged 70 years or older than in those under age 70 (BWT: 3.6+0.9 mm vs. 3.1+0.9 mm, p=0.022, DWT: 2.8±0.8 mm vs. 2.3±0.8 mm, p=0.007). In this older age group, the classification based on a BWT ≥4.0 mm showed 31% sensitivity, 87% specificity, and 65% diagnostic accuracy for the diagnosis of BOO, whereas DWT ≥3.0 mm showed 49% sensitivity, 82% specificity, and 69% diagnostic accuracy.
BWT and DWT were associated with BOO in men aged 70 years or older. Therefore, BWT and DWT will be a useful non-invasive parameter for deciding the management strategy for elderly men with symptomatic BPH. An appropriate measurement method should be established as soon as possible for further application of the relationship among BWT, DWT and BOO.
Investigative and clinical urology. 2020 Jul 16 [Epub ahead of print]
Juhyun Park, Jungyo Suh, Sangjun Yoo, Min Chul Cho, Hwancheol Son
Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea., Department of Urology, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea., Department of Urology, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea. .