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Journal of Peking University (Health Sciences) ›› 2025, Vol. 57 ›› Issue (2): 328-333. doi: 10.19723/j.issn.1671-167X.2025.02.017

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Correlation between urination intermittences and urodynamic parameters in benign prostatic hyperplasia patients

Ning LIU*(), Libo MAN, Feng HE, Guanglin HUANG, Jianpo ZHAI   

  1. Department of Urology, Beijing Jishuitan Hospital, Beijing 100035, China
  • Received:2021-09-14 Online:2025-04-18 Published:2025-04-12
  • Contact: Ning LIU E-mail:liuliuningning@sina.com

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Abstract:

Objective: To explore the impact factors and the clinical significance of the urination intermittences in benign prostatic hyperplasia (BPH) patients. Methods: A retrospective study was performed in BPH patients who underwent urodynamic studies in Beijing Jishuitan Hospital form January 2016 to June 2021. The patients were aged 45 to 84 years with a median age of 63 years, and all the patients had no previous history of neurological disease and had no positive findings in neurological examinations. All the patients had free uroflometry followed by urethral catheterization and urodynamic tests. The voiding work of bladder was calculated using the detrusor power curve method, and the voiding power of bladder and the voiding energy consumption were also calculated. The frequency of urination intermittences generated in uroflometry was also recorded and the patients were divided into different groups according to it. The detrusor pressure at maximal flow rate (PdetQmax), the maximal flow rate (Qmax), the bladder contractile index (BCI), the bladder outlet obstruction index (BOOI), the voiding work, the voiding power, and the voiding energy consumption were compared among the different groups. Multiva-riate analyses associated with presence of urination intermittences were performed using step-wise Logistic regressions. Results: There were 272 patients included in this study, of whom, 179 had no urination intermittence (group A), 46 had urination intermittence for only one time (group B), 22 had urination intermittence for two times (group C), and 25 had urination intermittence for three times and more (group D). The BCI were 113.4±28.2, 101.0±30.2, 83.3±30.2, 81.0±30.5 in groups A, B, C, and D, respectively; The voiding power were (29.2±14.8) mW, (16.4±9.6) mW, (14.5±7.1) mW, (8.5±5.0) mW in groups A, B, C, and D, respectively, and the differences were significant (P < 0.05). The BOOI were 41.6±29.3, 46.4±31.0, 41.4±29.0, 42.7±22.8 in groups A, B, C, and D, respectively; The voiding energy consumption were (5.41±2.21) J/L, (4.83±2.31) J/L, (5.02±2.54) J/L, (4.39±2.03) J/L in groups A, B, C, and D, respectively, and the differences were insignificant (P>0.05). Among the patients, 179 cases were negative in presence of urination intermittences and 93 cases were positive. Step-wise Logistic regression analysis showed that bladder power (OR=0.814, 95%CI: 0.765-0.866, P < 0.001), BCI (OR=1.023, 95%CI: 1.008-1.038, P=0.003), and bladder work (OR=2.232, 95%CI: 1.191-4.184, P=0.012) were independent risk factors for urination intermittences in the BPH patients. Conclusion: The presence of urination intermittences in the BPH patients was mainly influenced by bladder contractile functions, and was irrelevant to the degree of bladder outlet obstruction. The increase of frequency of urination intermittences seemed to be a sign of the decrease of the bladder contractile functions in the BPH patients.

Key words: Prostatic hyperplasia, Urodynamics, Urination disorders, Bladder function

CLC Number: 

  • R697.32

Figure 1

Urodynamic example of no urination intermittence (Group A) Pves, visceral pressure; Pabd, abdominal pressure; Pdet, detrusor pressure. 1 cmH2O=0.098 kPa."

Figure 2

Urodynamic example of urination intermittence for only one time (Group B) Abbreviations as in Figure 1."

Figure 3

Urodynamic example of urination intermittence for two times (Group C) Abbreviations as in Figure 1."

Figure 4

Urodynamic example of urination intermittence for three times and more (Group D) Abbreviations as in Figure 1."

Table 1

Urodynamic and bladder work statistics among subgroups according to the frequency of urination intermittences"

ItemsUrination intermittencesOverall P value
Group A Group B Group C Group D
Cases, n 179 46 22 25 272
Age/years 62±11 62±12 67±7 71±9 63±11 < 0.001
PdetQmax/cmH2O 62.1±24.4 62.0±28.2 53.4±28.7 53.6±24.4 60.6±25.5 0.222
Qmax/(mL/s) 10.1±4.9 7.8±3.9 6.0±2.0 5.5±2.4 9.0±4.8 < 0.001
BOOI 41.6±29.3 46.4±31.0 41.4±29.0 42.7±22.8 42.5±29.0 0.792
BCI 113.4±28.2 101.0±30.2 83.3±30.2 81.0±30.5 105.9±30.2 < 0.001
Residual urine/mL 0 (0, 120) 105 (24, 238) 86 (27, 114) 78 (60, 115) 39 (0, 129) 0.005
Bladder emptying ratio/% 81±15 68±28 77±15 77±15 78±20 0.021
Bladder work/J 1.33±0.71 1.01±0.61 1.08±0.77 0.98±0.71 1.22±0.71 0.007
Bladder power/mW 29.2±14.8 16.4±9.6 14.5±7.1 8.5±5.0 23.9±14.9 < 0.001
Voiding energy consumption/(J/L) 5.41±2.21 4.83±2.31 5.02±2.54 4.39±2.03 4.87±2.48 0.137

Table 2

Univariate analysis of factors for the presence of urination intermittences"

ItemsUrination intermittencesP value
Negative Positive
Cases, n 179 93
Age/years 62±11 65±14 0.002
PdetQmax/cmH2O 62.1±24.4 58.5±27.7 0.377
Qmax/(mL/s) 10.1±4.9 6.9±3.4 < 0.001
BOOI 41.6±29.3 44.3±28.7 0.282
BCI 113.4±28.2 92.2±32.4 < 0.001
Residual urine/mL 0 (0, 120) 84 (21, 114) 0.008
Bladder emptying ratio/% 81±15 73±17 0.001
Bladder work/J 1.33±0.71 1.01±0.67 0.001
Bladder power/mW 29.2±14.8 14.0±8.6 < 0.001
Voiding energy consumption/(J/L) 5.41±2.21 4.91±2.25 0.163

Table 3

Step-wise Logistic regression analysis of factors for the presence of urination intermittences"

Parameter β SE Wald P value OR 95%CI
Bladder power -0.206 0.031 42.642 < 0.001 0.814 0.765-0.866
BCI 0.023 0.008 8.989 0.003 1.023 1.008-1.038
Bladder work 0.803 0.320 6.279 0.012 2.232 1.191-4.184
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