To explore brain activation patterns on functional MRI (fMRI) in men with BPH and BOO before and after outlet obstruction procedures.
Men age ≥ 45 who failed conservative BPH therapy planning to undergo BOO procedures were recruited. Eligible men underwent a concurrent fMRI/urodynamics testing before and six months after BOO procedure. fMRI images were obtained via 3 Tesla MRI. Significant blood-oxygen-level-dependent (BOLD) signal activated voxels (p<0.05) were identified at strong desire to void and (attempt at) voiding initiation pre and post BOO procedure.
Eleven men were enrolled, of which seven men completed the baseline scan, and four men completed the six-month follow-up scan. Baseline decreased BOLD activity was observed in right inferior frontal gyrus (IFG), bilateral insula, inferior frontal gyrus (IFG) and thalamus. Significant changes in BOLD signal activity following BOO procedures were observed in the insula, IFG, and cingulate cortices.
This represents a pilot study evaluating cortical activity in men with BPH and BOO. Despite limitations we found important changes in supraspinal activity in men with BPH and BOO during filling and emptying phases at baseline and following BOO procedure, with the potential to improve our understanding of neuroplasticity secondary to BPH and BOO. This preliminary data may serve as the foundation for larger future trials.
Urology. 2022 Jul 18 [Epub ahead of print]
Logan C Hubbard, Zhaoyue Shi, Ricardo R Gonzalez, Khue Tran, Christof Karmonik, Yongchang Jang, Rose Khavari
Department of Urology, Houston Methodist Hospital, Houston, Texas, USA. Electronic address: ., MRI Core, Houston Methodist Research Institute, Houston, Texas, USA. Electronic address: ., Department of Urology, Houston Methodist Hospital, Houston, Texas, USA. Electronic address: ., Department of Urology, Houston Methodist Hospital, Houston, Texas, USA. Electronic address: ., MRI Core, Houston Methodist Research Institute, Houston, Texas, USA. Electronic address: ., Department of Urology, Houston Methodist Hospital, Houston, Texas, USA. Electronic address: ., Department of Urology, Houston Methodist Hospital, Houston, Texas, USA. Electronic address: .