Prognostic Value of a Combination of IPSS, Flow Rate and Residual Urine Volume Compared to Pressure-Flow Studies in the Preoperative Evaluation of Symptomatic BPH

• Published in: European urology Vol. 41; no. 3; pp. 246 - 249
• Main Authors: Porru, D., Jallous, H., Cavalli, V., Sallusto, F., Rovereto, B.
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier B.V 01.03.2002; Elsevier
• Subjects: Aged; Biological and medical sciences; BOO; BPH; Humans; IPSS; Male; Medical sciences; Nephrology. Urinary tract diseases; Predictive Value of Tests; Pressure-flow study; Prognosis; Prostatic Hyperplasia - diagnosis; Prostatic Hyperplasia - physiopathology; Prostatic Hyperplasia - surgery; Residual urine volume; Tumors of the urinary system; Urinary Bladder Neck Obstruction - diagnosis; Urinary Bladder Neck Obstruction - physiopathology; Urinary tract. Prostate gland; Urodynamics; Uroflowmetry; Residual urine volume; Uroflowmetry; BOO; BPH; IPSS; Pressure-flow study; Human; Urine; Urinary system disease; Prognosis; Prostate disease; Adenoma; Pressure; Symptomatology; Residue; Benign neoplasm; Flowmetry; Male genital diseases; Prostate; Comparative study
• ISSN: 0302-2838; 1873-7560
• DOI: 10.1016/S0302-2838(02)00021-0

Objective: Evaluate the predictive value of a combination of IPSS, uroflowmetry and ultrasound determination of residual urine volume in the determination of bladder outflow obstruction (BOO) and in predicting treatment outcome. Methods: Forty-five out of a group of 60 BPH symptomatic patients were included. Preoperative evaluation: urine culture, PSA, uroflowmetry with sonographic measurement of post-void residual urine, DRE, IPSS with quality of life questions and pressure-flow study. Selection criteria for surgery were IPSS>16 and Q max<10 ml/s. Transurethral resection of the prostate was performed in these patients; the control visit was performed at 3 months. Treatment success was defined as Q max above 15 ml/s, residual urine of less than 100 ml, a 50% reduction in IPSS and absence of urinary retention. Results: Urodynamic abnormalities were found in 42 patients (93.3%): 19 had detrusor instability, 5 patients showed impaired contractility, 37 patients had proven BOO, and 8 patients were unobstructed or mildly obstructed. The overall success rate was 86% when measured by the IPSS. Its preoperative value was 16.9, and dropped significantly to 4 ( P=0.005). The score improved significantly after surgery only in the obstructed group compared to the non-obstructed group ( P=0.001), however preoperative IPSS did not correlate with objective treatment results. Conclusions: A high proportion of patients successfully operated (71.1%) had a combination of IPSS>16 and Q max<10 ml/s, although BOO could not be accurately predicted with non-invasive methods alone. Patients with no or mild infravesical obstruction had only minimal improvement of IPSS and uroflowmetry following surgery.