Abstract
BackgroundNumerous studies indicated that Intravesical prostatic protrusion is relevant to prognosis of LUTS, however, the confounding effect that is brought about by prostate volume, urethra anterior curvature angle and other factors makes it hard to evaluate the role of intravesical prostatic protrusion in clinical observation.MethodsWe proposed a fluid structural interaction analysis approach. 3D models were constructed based on MRI images, and prostatic urethra diameters were calibrated with urodynamic data. Comparisons of urine flow dynamics were made between models with various degree of intravesical prostatic protrusion, while the intravesical pressure, anterior urethra curvature angle and diameter of prostatic urethra were same among all models to rule out their confounding effects.ResultsSimulation result showed that the decrement of diameter and increment of variation in cross-sectional area for prostatic urethra were related to the degree of intravesical prostatic protrusion. Such deformation would lead to deterioration of flow efficiency and could compromise the effect of bladder outlet obstruction alleviation treatment.ConclusionsThese results provided further evidence for intravesical prostatic protrusion being an independent risk factor for bladder outlet obstruction severity and demonstrated that intravesical prostatic protrusion would be a promising marker in clinical decision making.Electronic supplementary materialThe online version of this article (doi:10.1186/s12894-015-0081-y) contains supplementary material, which is available to authorized users.
Highlights
Numerous studies indicated that Intravesical prostatic protrusion is relevant to prognosis of Lower urinary tract symptom (LUTS), the confounding effect that is brought about by prostate volume, urethra anterior curvature angle and other factors makes it hard to evaluate the role of intravesical prostatic protrusion in clinical observation
Our results showed that intravesical pressure above 7840.8 Pa was enough to cause prominent deformation of the prostate in model 3, which would lead to constriction of prostatic urethra
Three dimensional (3D) model of lower urinary tract was constructed from Magnetic Resonance Imaging (MRI) images and adjusted according to urodynamic data
Summary
Numerous studies indicated that Intravesical prostatic protrusion is relevant to prognosis of LUTS, the confounding effect that is brought about by prostate volume, urethra anterior curvature angle and other factors makes it hard to evaluate the role of intravesical prostatic protrusion in clinical observation. Population based data indicated that 10 % of male between 40 to 79 years old had an IPP of 10 mm or greater [2]. IPP is considered as a prognostic factor for LUTS [3, 4]. The fact that IPP can be evaluated with non-invasive trans-abdominal ultra-sound made it a promising candidate for initial assessment of LUTS patient [5]. One key issue the confounding effect caused by prostate volume variation and urethra curvature angle
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