Role of poor urethral sphincter relaxation in men with voiding dysfunction refractory to α-blocker therapy: Clinical characteristics and predictive factors.
Low Urin Tract Symptoms
; 11(1): 8-13, 2019 Jan.
Article
in En
| MEDLINE
| ID: mdl-28840669
ABSTRACT
OBJECTIVES:
This study evaluates the diagnostic value of poorly relaxed external sphincter (PRES) in men with voiding dysfunction. We analyzed clinical and video-urodynamic characteristics to identify predictive factors of PRES in patients with lower urinary tract symptoms (LUTS) refractory to α-1 adrenoceptor blocker (α-blocker) therapy.METHODS:
This retrospective study included 3379 men with LUTS in whom the initial 1-month α-blocker therapy failed. Clinical parameters and video-urodynamic results were analyzed. Patients with bladder outlet disorders including bladder neck obstruction (BNO), benign prostatic obstruction (BPO), urethral stricture (US), or PRES were categorized according to video-urodynamic findings. Predictive factors for PRES were analyzed.RESULTS:
A total of 3379 men were included in this study. Among the patients with voiding dysfunction, 905 (43.6%) had BPO, 624 (30.0%) had BNO, 487 (23.4%) had PRES, and 62 (3.0%) had US. Patients with PRES were younger and had a higher maximum flow rate, larger bladder capacity, smaller total prostate volume (TPV) and transition zone index, and a lower rate of LUTS of urgency or urge urinary incontinence (UUI) than other groups. On multivariate analysis, only small TPV and lower urgency/UUI rate were predictive factors of PRES. A scale composed of voided volume, TPV, and urgency/UUI predicted PRES with high specificity.CONCLUSIONS:
PRES was the etiology of voiding dysfunction in 23.4% of the men with LUTS refractory to α-blocker therapy. A simple scale composed of voiding volume, TPV, and urgency/UUI was useful in predicting the presence of PRES before video-urodynamic studies.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Urethral Diseases
/
Lower Urinary Tract Symptoms
Type of study:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Aged
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
Low Urin Tract Symptoms
Year:
2019
Document type:
Article
Affiliation country:
Taiwan