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

  • Ning LIU ,
  • Libo MAN ,
  • Feng HE ,
  • Guanglin HUANG ,
  • Jianpo ZHAI
Expand
  • Department of Urology, Beijing Jishuitan Hospital, Beijing 100035, China
LIU Ning, e-mail, liuliuningning@sina.com

Received date: 2021-09-14

  Online published: 2025-04-12

Copyright

, 2025, All rights reserved. Unauthorized reproduction is prohibited.

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.

Cite this article

Ning LIU , Libo MAN , Feng HE , Guanglin HUANG , Jianpo ZHAI . Correlation between urination intermittences and urodynamic parameters in benign prostatic hyperplasia patients[J]. Journal of Peking University(Health Sciences), 2025 , 57(2) : 328 -333 . DOI: 10.19723/j.issn.1671-167X.2025.02.017

References

1 Reynard JM , Yang Q , Donovan JL , et al. The ICS-"BPH" Study: Uroflowmetry, lower urinary tract symptoms and bladder outlet obstruction[J]. Br J Urol, 1998, 82 (5): 619- 623.
2 Reddy SVK , Shaik AB . Non-invasive evaluation of bladder outlet obstruction in benign prostatic hyperplasia: A clinical correlation study[J]. J Urol, 2019, 17 (4): 259- 264.
3 Hoag N , Gani J . Underactive bladder: Clinical features, urodynamic parameters, and treatment[J]. Int Neurourol J, 2015, 19 (3): 185- 189.
4 Homma Y , Gotoh M , Kawauchi A , et al. Clinical guidelines for male lower urinary tract symptoms and benign prostatic hyperplasia[J]. Int J Urol, 2017, 24 (10): 716- 729.
5 Parsons JK , Dahm P , K?hler TS , et al. Surgical management of lower urinary tract symptoms attributed to benign prostatic hyperplasia: AUA guideline amendment 2020[J]. J Urol, 2020, 204 (4): 799- 804.
6 Alexander LF , Oto A , Allen BC , et al. ACR Appropriateness Criteria? lower urinary tract symptoms: Suspicion of benign prostatic hyperplasia[J]. J Am Coll Radiol, 2019, 16 (11S): S378- S383.
7 Barry MJ , Fowler FJ Jr , O'Leary MP , et al. The American Urological Association symptom index for benign prostatic hyperplasia[J]. J Urol, 2017, 197 (2S): S189- S197.
8 Li R , Zhu Q , Nibouche M , et al. Urine flow rate curve shapes and their descriptors[J]. Neurourol Urodyn, 2018, 37 (8): 2938- 2944.
9 Sch?fer W . Analysis of bladder-outlet function with the linearized passive urethral resistance relation, linPURR, and a disease-specific approach for grading obstruction: From complex to simple[J]. World J Urol, 1995, 13 (1): 47- 58.
10 Drake MJ , Doumouchtsis SK , Hashim H , et al. Fundamentals of urodynamic practice, based on International Continence Society good urodynamic practices recommendations[J]. Neurourol Urodyn, 2018, 37 (S6): S50- S60.
11 Rosier PFWM , Schaefer W , Lose G , et al. International Continence Society good urodynamic practices and terms 2016: Urodynamics, uroflowmetry, cystometry, and pressure-flow study[J]. Neurourol Urodyn, 2017, 36 (5): 1243- 1260.
12 Liu N , Man LB , He F , et al. Work capacity of the bladder during voiding: A novel method to evaluate bladder contractile function and bladder outlet obstruction[J]. Chin Med J (Engl), 2015, 128 (24): 3329- 3334.
13 刘宁, 满立波, 何峰, 等. 逼尿肌功率曲线分析在尿动力学研究中的应用[J]. 中华泌尿外科杂志, 2015, 36 (3): 224- 227.
14 Smith PP , Birder LA , Abrams P , et al. Detrusor underactivity and the underactive bladder: Symptoms, function, cause-what do we mean? ICI-RS think tank 2014[J]. Neurourol Urodyn, 2016, 35 (2): 312- 317.
15 Osman NI , Esperto F , Chapple CR . Detrusor underactivity and the underactive bladder: A systematic review of preclinical and clinical studies[J]. Eur Urol, 2018, 74 (5): 633- 643.
16 Chai TC , Kudze T . New therapeutic directions to treat underactive bladder[J]. Investig Clin Urol, 2017, 58 (Suppl 2): S99- S106.
17 Gammie A , Kitney D , Drake M , et al. The calculation and comparison of the detrusor contractility parameter and Watts factor[J]. Neurourol Urodyn, 2018, 37 (8): 2745- 2752.
18 Zhao Z , Azad R , Yang JH , et al. Progressive changes in detrusor function and micturition patterns with chronic bladder ischemia[J]. Investig Clin Urol, 2016, 57 (4): 249- 259.
19 Namitome R , Takei M , Takahashi R , et al. A prediction model of detrusor underactivity based on symptoms and noninvasive test parameters in men with lower urinary tract symptoms: An analysis of a large group of patients undergoing pressure-flow studies[J]. Urol, 2020, 203 (4): 779- 785.
Outlines

/