Abstract
BackgroundThe correlation between modified bladder outlet obstruction index (MBOOI) and surgical efficacy still remains unknown. The purpose of the study was to investigate the clinical value of the MBOOI and its use in predicting surgical efficacy in men receiving transurethral resection of the prostate (TURP).MethodsA total of 403 patients with benign prostate hyperplasia (BPH) were included in this study. The International Prostate Symptom Score (IPSS), quality of life (QoL) index, transrectal ultrasonography, and pressure flow study were conducted for all patients. The bladder outlet obstruction index (BOOI) (PdetQmax–2Qmax) and MBOOI (Pves–2Qmax) were calculated. All patients underwent TURP, and surgical efficacy was accessed by the improvements in IPSS, QoL, and Qmax 6 months after surgery. The association between surgical efficacy and baseline factors was statistically analyzed.ResultsA comparison of effective and ineffective groups based on the overall efficacy showed that significant differences were observed in PSA, Pves, PdetQmax, Pabd, BOOI, MBOOI, TZV, TZI, IPSS-t, IPSS-v, IPSS-s, Qmax, and PVR at baseline (p < 0.05). Binary logistic regression analysis suggested that MBOOI was the only baseline parameter correlated with the improvements in IPSS, QoL, Qmax, and the overall efficacy. Additionally, the ROC analysis further verified that MBOOI was more optimal than BOOI, TZV and TZI in predicting the surgical efficacy.ConclusionAlthough both MBOOI and BOOI can predict the clinical symptoms and surgical efficacy of BPH patients to a certain extent, however, compared to BOOI, MBOOI may be a more useful factor that can be used to predict the surgical efficacy of TURP.Trial registration retrospectively registered.
Highlights
The correlation between modified bladder outlet obstruction index (MBOOI) and surgical efficacy still remains unknown
A comparison of the overall efficacy in the effective and ineffective groups revealed significant differences in prostatespecific antigen (PSA) (p = 0.021), Pves (p < 0.001), PdetQmax (p < 0.001), Pabd (p < 0.001), BOO index (BOOI) (p < 0.001), MBOOI (p < 0.001), transitional zone volume (TZV) (p = 0.022), transitional zone index (TZI) (p = 0.025), International Prostate Symptom Score (IPSS)-t (p < 0.001), IPSS-v (p = 0.014), IPSS-s (p < 0.001), Maximum urine flow rate (Qmax) (p = 0.010), and PVR (p = 0.006) at baseline, but significant differences were not observed in age (p = 0.105), Table 2 Baseline clinical characteristics and comparison of preoperative characteristics between the two groups classified by the overall surgical efficacy
Additional studies with larger samples are needed to further elucidate the relationship and mechanism between MBOOI and abdominal pressure with Benign prostatic hyperplasia (BPH) and the surgical effect. Conclusions both MBOOI and BOOI can predict the urinary symptoms in men with low urinary tract symptom (LUTS)/BPH to a certain extent, there was a stronger correlation between MBOOI and LUTS
Summary
The correlation between modified bladder outlet obstruction index (MBOOI) and surgical efficacy still remains unknown. The purpose of the study was to investigate the clinical value of the MBOOI and its use in predicting surgical efficacy in men receiving transurethral resection of the prostate (TURP). Benign prostatic hyperplasia (BPH), whose prevalence progressively increases with age, is one of the most common diseases in middle-aged and elderly men [1]. Pressure-flow studies (PFSs) have been recommended as the gold standard for diagnosing bladder outlet obstruction (BOO) by the International Continence Society, among which the BOO index (BOOI) has become best-known and most widely-adopted urodynamic parameter [2, 3]. In our previous study, it was observed there was no significant correlation between BOOI and symptoms and the maximum urine flow rate (Qmax) in BPH patients [4]. Research has been carried out to assess the correlation between abdominal pressure and BOO, and it has been previously determined that a modified BOOI (MBOOI) that takes into account abdominal pressure can better predict the BOO than the BOOI [5]
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