Optimizing Treatment Strategies of Prostate Adenoma through Analytical Urodynamics

Abstract

Aim: To investigate the role of urinary obstruction in determining surgical indications based on analytical urodynamics.Materials and methods. To collect observational data, a cohort of patients was selected from those receiving treatment at the Urination Pathology Centre in Vladivostok due to urinary disorders and prostate adenoma. This cohort consisted of patients aged 50 to 73 years (mean age 60.5 ± 8.2 years), with observation periods ranging from 2 to 29.3 months (mean duration 15.5 ± 13.5 months). During a two-day home uroflow monitoring session, the severity of urinary symptoms was assessed using the IPSS questionnaire prior to each monitoring event. The study utilized a domestically designed two-sensor SIGMA uroflowmeter in conjunction with LEVELEST software.Results. The study demonstrated that in patients from all three groups undergoing therapy with an alpha-1 adrenergic blocker, there was a significant reduction in clinical symptoms as measured by the IPSS questionnaire and an increase in the average effective volume of urination. However, despite these improvements, the groups exhibited differing dynamics in urinary obstruction, which ultimately determined the indications for surgical intervention.Conclusion. Home uroflow monitoring with the Sigma uroflowmeter provides an objective assessment of the lower urinary tract function in patients with bladder outlet obstruction, focusing on the urinary obstruction indicator dynamics. Repeated pharmacological testing in patients with prostate adenoma shows potential for long-term patient management, aiming to prevent detrusor failure and evaluate the efficacy of conservative therapy. Analytical urodynamic methods enable the establishment of surgical treatment indications based on uroflow monitoring outcomes.