Cause Of Bladder Outlet Obstruction Research Articles

Magnitude and associated factors of benign prostatic hyperplasia among male patients admitted at surgical ward of selected governmental hospitals in Sidamma region, Ethiopia 2021

BackgroundBenign prostatic hyperplasia (BPH) is the most common cause of bladder outlet obstruction and voiding symptoms in elderly men, and it affects more than 50 % of men over 60 years of age globally. MethodsBetween October 15 and November 15, 2021, 143 male patients admitted to the surgical wards of the Hawassa University Comprehensive Specialized Hospital (HUCSH), the Adare General Hospital (AGH), and the Yirgalem General Hospital in Hawassa City were involved. Data were gathered utilizing a pretested, structured, interviewer-administered questionnaire and patient review checklist employing a purposive sample technique. A binary logistic regression model, which examines the relationship between the dependent and independent variables, was used to analyze the data using SPSS version 20. ResultsThe magnitude of benign prostate hyperplasia (BPH) was 27 (18.9 %). Old age >=75 years (AOR = 0.07; 95 % CI: 0.005–1.024), being smokers (AOR = 0.261; 95 % CI: 0.078–00.871), positive familial history of BPH (AOR = 0.13; 95 % CI: 0.038–00.428), patients with renal disease (AOR = 5.724; 95 % CI: 1.669–19.631), and patients with a history of difficulties with sexual activity (AOR = 0.17; 95 % CI: 0.034–00.830) were found to be statistically associated with the presence of BPH. ConclusionsIn conclusion, the findings of this study revealed that BPH was a prevalent disease among men. Factors that could potentially increase the risk of benign prostatic hyperplasia were old age, positive family history, smoking, renal disease, and difficulties with sexual activities.

Prospective Study Comparing Lower Urinary Tract Symptoms (LUTS) Before and After Laparoscopic Inguinal Hernia Surgery in Adult Patients With and Without Benign Prostatic Hyperplasia with Repaired Hernia

Objective: Benign prostatic hyperplasia (BPH) is the most prevalent cause of bladder outlet obstruction in elderly males. The occurrence of both inguinal hernia and BPH with lower urinary tract symptoms increases with age. This study is aimed at comparing lower urinary tract syndrome using the International Prostate Symptom Score (IPSS) before and after laparoscopic inguinal hernia surgery.Material and Methods: This prospective study was conducted at Somdech Phra Pinklao Hospital. Thirty-five patients who presented with lower urinary tract symptoms (LUTS) and underwent inguinal hernia repair were selected according to inclusion criteria and evaluated using an IPSS scoring chart for urinary symptoms before and after an operation.Results: Thirty-five patients who presented with LUTS symptoms and underwent inguinal hernia repair between 1 December 2020 and 30 November 2021 were included in the study. Statistical analysis by Wilcoxon Signed-Rank test for the 35 patients resulted in an average IPSS that was compared at 2 weeks with a preoperative score of 6.54 and postoperative score of 4.69 (p-value<0.001), preoperative obstructive score of 2.6 and postoperative score of 1.51 (p-value<0.001), preoperative irritative score of 3.94 and postoperative score of 3.17 (p-value<0.001). At 4 weeks, there was an average preoperative IPSS score of 6.54 and postoperative score of 3.86 (p-value<0.001), preoperative of obstructive score of 2.6 and postoperative score of 1.03 (p-value<0.001), and preoperative irritative score of 3.94 and postoperative score of 2.83 (p-value<0.001). At 8 weeks, there was an average preoperative IPSS score of 6.54 and postoperative score of 3.49 (p-value<0.001), preoperative obstructive score of 2.6 and postoperative score of 0.80 (p-value<0.001), and preoperative irritative score of 3.94 and postoperative score of 2.69 (p-value<0.001).Conclusion: Comparison of LUTS before and after laparoscopic inguinal hernia surgery showed a significant decrease in the IPSS score after laparoscopic surgery inguinal hernia at 2, 4 and 8 weeks for both obstructive and irritative scores.

Prevalence and Distribution of Postvoid Residual Urine Volume in a Hospital-Based Sample of Men with Symptomatic Benign Prostatic Hyperplasia.

Benign prostatic hyperplasia (BPH) is a known cause of bladder outlet obstruction (BOO) in aging men. Patients present with lower urinary tract symptoms (LUTS), elevated postvoid residual urine (PVR), and reduced peak flow rate of urine. Although urodynamic study is the gold standard for diagnosing and quantifying BOO, it is invasive and as such urologists in their routine practice frequently rely on less invasive methods like PVR estimation to objectively assess BOO. To study the prevalence and distribution of PVR in a hospital-based population of men with symptomatic BPH. Patients aged 40 years and above were enrolled for the study. History was taken from each of the 170 participants recruited, and physical examination was done including digital rectal examination. Every one of them completed the International Prostate Symptom Score (IPSS) questionnaire and also had ultrasonography assessment of PVR. Relevant laboratory investigations (PSA, renal function test, full blood count, urinalysis, and urine culture) and uroflowmetry to determine the peak flow rate of urine (Qmax) were done. A total of 170 subjects who met the inclusion criteria were enrolled for this study. The mean age of the subjects was 63.70 ± 9.92 years with a range of 42-88 years. The subjects had a mean PSA of 2.68 ± 0.91 ng/ml and a mean prostate volume of 70.8 ± 39.5 ml. The prevalence of significant PVR was 57.06%. The distribution of PVR was skewed with values ranging from 4.0 ml to 382.9 ml, a median value of 60.5 ml (interquartile range, IQR, =25.0-100.76), and a mean value of 77.70 ± 69.30 ml. An IPSS range of 8 to 23 with a mean value of 13.64 ± 4.14 and a median value of 13 (interquartile range = 10.0-16.0) was observed. The Qmax range was from 5 ml/s to 50 ml/s with a mean value of 20.25 ± 9.70 ml/s, and a median value of 18.0 ml/s (interquartile range = 14.0-24.0). This study showed that the prevalence of significant PVR volume among men with symptomatic BPH in our environment is high. There was also a high variation in the distribution of PVR among the subjects. Therefore, it is essential to create more public awareness especially among men in their fourth decade of life and above to visit a urologist whenever they have BPH symptoms so as to avoid impairment in quality of life and renal function associated with neglected significant PVR.

Nonneurogenic female bladder outlet obstruction: Conservative and medical management.

In nonneurogenic female bladder outlet obstruction (BOO), management goals include reduction of outlet resistance to increase urinary outflow and improve bladder voiding to prevent or reduce lower and upper urinary tract (LUT and UUT) function deterioration, by correcting the underlying etiology. As significant progress has been achieved in the conservative and pharmacological management of nonneurogenic female BOO, the purpose of this article is to review and summarize the current literature. For this narrative review, a PubMed® search was performed by cross-referencing the keywords "female bladder outlet obstruction," "female voiding dysfunction," "conservative management," "pharmacological management," and "treatment" with various terms related to the management of female BOO. Clinical practice guidelines and landmark reviews from the most renowned experts in the field were also used. This review discusses and summarizes the conservative and pharmacological management of nonneurogenic female BOO based on the most relevant data currently available in the literature. The recent advances in the understanding of underlying mechanisms involved in female BOO allow for more individualized management. Conservative and pharmacological options show interesting outcomes, particularly in the context of a functional cause of BOO. Overall, the level of evidence is still low regarding the use of conservative and pharmacological measures and more long-term data are required.

154 A Scoping Review of the Management of Benign Prostate Hyperplasia in Africa

Abstract Aim Benign prostatic hyperplasia (BPH) is a non-malignant prostate gland enlargement of unknown cause that affects more than 50% of men over 60 and is the most common cause of bladder outlet obstruction and voiding symptoms. BPH is treated primarily with watchful waiting, phytotherapy, and medical or surgical options. In this study, we sought to examine the different management practices in African urological centres, outcomes of management, and complications. Method A literature search was conducted using PubMed, African Journal Online, and Google Scholar regarding the management of BPH from inception till date. Articles were selected based on their relevance to the management of benign prostatic enlargement in Africa. Results are reported according to the PRISMA extension for scoping reviews. Results Exactly 2999 patients were included in the study. Seventy-three (73.49%) percent of these patients totalling 2204, underwent surgical management of BPH, 124 (4.13%) patients were treated with phytomedicines, and 684 (22.80%) patients were treated with medical therapy. A total of 808 patients opted for non-surgical treatment for BPH in the included studies. In this group, 124 were treated using phytochemicals or natural herbs, and 648 were treated with standard prescription medications. Conclusions While surgical treatment for benign prostatic enlargement is shifting towards minimally invasive procedures in the developed world, open prostatectomy is still quite popular in Africa. Further research should focus not only on the reason for these disparities in management but also on the rationale for the selection of medical, surgical, or phytotherapy in African urological centres.

Serum prostate specific antigen is a good indicator of prostatic volume in men with benign prostatic hyperplasia.

Benign prostatic hyperplasia (BPH) is the most common cause of bladder outlet obstruction in men over the age of 50 years. An association between the prostate specific antigen (PSA), International Prostate Symptoms Score (IPSS) and prostate volume (PV) may be instrumental in determining patients who may benefit from treatment. Targeted therapy will reduce the cost of care because it is unwise to treat all men with prostate enlargement to prevent complications when the risk of occurrence is negligible. To determine the correlation between the PSA, IPSS and PV in men of African descent. This was a cross sectional analysis involving 92 patients diagnosed as having symptomatic BPH at the Ho Teaching Hospital. The data were collected using standardised questionnaires. The IPSS determined urinary symptom severity. The PV was determined using a transabdominal ultrasound machine. Serum PSA was retrieved from the electronic medical records. The mean PV was 61.04 cm3 ± 21.95 cm3, the mean PSA was 4.21 ng/mL ± 3.85 ng/mL, and mean IPSS of 21.59 ± 3.78. The Pearson's correlation between PV and PSA was 0.283 (p = 0.01), between PV and IPSS was 0.108 (p = 0.30), and finally, between Serum PSA and IPSS Score was -0.086 (p = 0.42). This study showed that serum PSA has a positive correlation with PV. However, IPSS had no significant association with PSA or PV in patients with BPH.Contribution: This study provides insights into the implications of clinical parameters on the management of prostate enlargement.

A Scoping Review of the Management of Benign Prostate Hyperplasia in Africa.

Benign prostatic hyperplasia (BPH) is a non-malignant prostate gland enlargement of unknown cause that affects more than 50% of men over 60 and is the most common cause of bladder outlet obstruction and voiding symptoms. BPH is treated primarily with watchful waiting, phytotherapy (herbs), and medical or surgical options. In this study, we sought to examine the different management practices in African urological centers, outcomes of management, and complications. A literature search was conducted using PubMed, African Journal Online, and Google Scholar regarding the management of BPH from inception till date. Articles were selected based on their relevance to the management of benign prostatic enlargement in Africa. Results are reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping reviews. The studies included were conducted from 1997 to 2022. They were from eight different African countries (Nigeria, Kenya, Togo, Ethiopia, Egypt, South Africa, Ghana, and Congo), with Nigeria contributing the most with 10 studies. Exactly 2999 patients were included in the study. Seventy-three (73.49%) percent of these patients totaling 2204, underwent surgical management of BPH, 124 (4.13%) patients were treated with phytomedicines or herbs, and 684 (22.80%) patients were treated with medical therapy. The complications and outcomes were studied and collated. A total of 808 patients opted for non-surgical treatment for BPH in the included studies. In this group, 124 were treated using phytochemicals or natural herbs, and 648 were treated with standard prescription medications. While surgical treatment for benign prostatic enlargement is shifting towards minimally invasive procedures in the developed world, open prostatectomy is still quite popular in Africa. Further research should focus not only on the reason for these disparities in management but also on the rationale for the selection of medical, surgical, or phytotherapy in African urological centres.

274 Retrospective Cohort Study of the Long-Term Outcome of Posterior Urethral Valve – A Single Centre Experience

Abstract Aim Posterior Urethral Valves (PUV) are the most common cause of bladder outlet obstruction in male infants. Despite definitive management by endoscopic valve resection, some patients develop persistent bladder dysfunction and progressive chronic kidney disease (CKD). This study aims to evaluate the long-term complications of PUV, as well as evaluate bladder and renal dysfunction pre- and post-operatively. Method A retrospective review of all the patients who received PUV ablation between 2012 to 2016 in a tertiary paediatric urology centre. Data collected included demographics, laboratory and radiographic investigations, and surgical outcomes. The data were analysed with SPSS. Results Twenty-three patients were included in the study; antenatal diagnosis was made in 43.5% (n=10) with 56.5% (n=13) postnatally. Mean follow-up time was 7.1±2.3 years (4.8–9.4). Voiding dysfunction was the most common complication in later life (34.8%, n=8), followed by CKD (13.0%, n=3), kidney transplant (8.7%, n=2), hypertension (8.7%, n=2) and mortality (8.7%, n=2). There was a statistically significant difference (p=0.003) between pre- and post-operative creatinine values. 5 patients who had creatinine values postoperatively of >88.4μmol/L (21.7%) sustained poor renal outcomes. Radiologically, there was a significant improvement in the anteroposterior (AP) diameter of the renal pelvis and kidney growth based on current, post-operative and preoperative ultrasound (p<0.05). Nevertheless, there was no statistically significant improvement in ureteric dilatation. Conclusions Post PUV ablation, urinary incontinence and CKD remain the most substantial long-term outcome. Proactive multidisciplinary management with careful follow-up are essential to reduce the burden of the disease.

Correlation between prostate volume measured by ultrasound and symptoms severity score in patients with benign prostatic hypertrophy in Southeastern Nigeria.

Benign prostatic hypertrophy (BPH) is a common urological condition in men older than 50 years. It is important in the aetiologies of life-threatening obstructive uropathies. Ultrasound measurement of prostate volume is non-invasive, easily available, and a cost-effective method, useful in assessing bladder outlet obstruction (BOO). The International Prostate Symptoms Score (IPSS) on the other hand objectively assesses symptoms severity in BOO patients. This study was aimed at determining the correlation between ultrasound-measured prostate volume and IPSS in men with BPH. Following ethical approval from the Nnamdi Azikiwe University Teaching Hospital Ethical Committee, 100 patients who met the inclusion criteria and were diagnosed with clinical BPH were enrolled into the study. They had no other identifiable cause of BOO except BPH after clinical evaluation. The IPSS, Quality of life score (QOL), and prostate volumes were measured. Correlation between prostate volume, IPSS, and QOL were done using SPSS version 20. P value <0.05 was considered significant. The mean age of patients was 69.3 ± 10.6 years with a range of 48-100 years. The mean prostate volume, IPSS, and QOL were 96.0 ± 70.5 cm3, 15.63 ± 8.6, and 4.8 ± 1.3, respectively. The highest recorded IPSS was 35 and the lowest was 4, whereas the smallest and largest recorded prostate volumes were 19 cm3 and 350 cm3, respectively. Nocturia was the major IPSS subscore. There was a weak positive correlation between prostate volume and IPSS in men with BPH (r = +0.109; P = 0.28) and between prostate volume and QOL (r = +0.072; P = 0.45). There was also a weak positive correlation between patients with only severe symptoms and corresponding prostate volumes (r = +0.122; P = 0.125). The correlation between patients with severe symptoms and their corresponding QOL was strong (r = +0.537; P = 0.135, respectively). These findings were, however, not statistically significant. There is a weak positive correlation between prostate volume measured by ultrasound and symptoms severity scores in patients with BPH, although not statistically significant. This may be as a result of the small sample size. A larger sample size may be able to achieve statistical significance.

MRI and MR voiding cystourethrography in the evaluation of male primary bladder neck obstruction: preliminary experience.

Evaluation of male with primary bladder neck obstruction (PBNO) using MRI and MR voiding cystourethrography (MR-VCU) to study both anatomical aspects of bladder neck and urethral lumen. In this retrospective study 21 male patients (mean age 33 ± 14) with urodynamic diagnosis of PBNO and 5 healthy volunteers ((mean age 28 ± 2) as control group were enrolled. Both patients and control group underwent 1.5T MRI. Sagittal and oblique coronal Turbo-Spin-Echo T2-weighted scans were performed. Only patients underwent MR voiding cystourethrography (MR-VCU) performed with T1-weighted spoiled 3D gradient-echo sagittal acquisitions. Bladder lumen was filled with contrast-material-enhanced urine. Blinded test by two radiologists was performed to evaluate causes of bladder outlet obstruction evaluating MR-VCU. Anatomical MRI features of both control group and patients were compared in consensus by senior radiologist and urologist using the analysis of variance (ANOVA) test. MRI allowed evaluation of the bladder neck muscular structures. We found 4 groups of PBNO patients: 52% hypertrophy of posterior lip of bladder sphincter; 20% asymmetry of lateral portion of bladder sphincter; 14% bladder neck cyst; 14% showed normal aspect of bladder neck. Comparison between the control group and first and second PBNO groups was considered statistically significant (p < 0.05) with diagnostic accuracy of 87%. Only 13 patients (61%) were able to perform MR-VCU and radiologists always made the diagnosis of PBNO. MRI together with MR-VCU provides useful anatomical and functional information in the study of bladder neck and urethral lumen. These preliminary results suggest that MRI could substitute for standard cystourethrogram in patients with PBNO.

A Brunn’s cyst as a cause of bladder outlet obstruction: a case report

A Brunn’s cyst in the proximity of the bladder neck is a rare cause of bladder outlet obstruction. This case study concerns a 45-year-old male presenting with bladder outlet obstruction secondary to a Brunn’s cyst. A provisional diagnosis of Brunn’s cyst was based on ultrasonography, CT scan and cystoscopic examination which indicated a cystic lesion at the bladder neck. Transurethral resection of the cyst was performed with successful resolution of the obstructive voiding symptoms. The final diagnosis of this case based on the pathology is a Brunn’s cyst.

Congenital anterior urethral diverticula with posterior urethral valve: rare combination in a neonate: a case report

Congenital Anterior Urethral Diverticulum (CAUD) is defined as a cystic dilatation of the anterior urethra and is one of the rare causes of bladder outlet obstruction. The association of this urethral anomaly with the posterior urethral valve is extremely rare. In this case, we found the association of congenital urethral diverticulum and posterior urethral valve and we aimed to present it.

Congenital anterior urethral diverticula with posterior urethral valve: rare combination in a neonate: a case report

Congenital Anterior Urethral Diverticulum (CAUD) is defined as a cystic dilatation of the anterior urethra and is one of the rare causes of bladder outlet obstruction. The association of this urethral anomaly with the posterior urethral valve is extremely rare. In this case, we found the association of congenital urethral diverticulum and posterior urethral valve and we aimed to present it.

Primary bladder neck obstruction is one of the rare causes for renal failure in young adult males

BackgroundPrimary bladder neck obstruction (PBNO) is one of the causes of bladder outlet obstruction (BOO) and rarely results in renal failure. We are presenting the clinical characteristics of young male patients with PBNO and renal failure.MethodsMedical records of patients between 18 and 40 years old with PBNO and renal failure were retrospectively reviewed (2014–2020). Patients with anatomical cause of BOO, and any urological or systemic disease or previous history of any surgical procedure associated with renal failure and/or lower urinary tract dysfunction were excluded. Serum creatinine measurement, ultrasonography, uroflowmetry, cystoscopy, and videourodynamics were performed.ResultsSeven male patients were identified, and the mean age of the patients was 28.8 years. Symptom duration was > 5 years in all patients. Two patients presented with difficult voiding, and five patients presented with both storage and voiding lower urinary tract symptoms (LUTS). Three patients were previously misdiagnosed as overactive bladder. At presentation, serum creatinine levels were between 1.7 and 2.4 mg/dl. One patient was under hemodialysis treatment and waiting for renal transplantation. Mean detrusor pressure at maximum measured flow rate, mean maximum flow rate (Qmax), and mean average flow rate (Qave) was 67.6 cm H2O, 9.5 ml/s, and 5.5 ml/s, respectively. With α-blocker treatment, serum creatinine levels were stable or decreased after 12 months follow-up and mean Qmax and Qave were increased to 14.8 ml/s and 10.1 ml/s, respectively.ConclusionsPBNO is a common disease in young men presenting with a long history of LUTS. Videourodynamics is mandatory for accurate diagnosis, but having a high clinical suspicion for PBNO is key to ensure the diagnosis. Clinicians should pay more attention to PBNO in young male patients with a long history of LUTS to prevent misdiagnosis, incorrect treatment, and possible decrease in renal function by years.

A rare cause of bladder outlet obstruction: Vesical diverticular calculus

Vesical diverticula are herniations of the bladder mucosa and submucosa through the muscular wall of the bladder. A calculus in diverticulum is an unusual finding. It is usually secondary to bladder outlet obstruction [1]. The patient typically presents with lower urinary tract symptoms, lower abdominal pain or abdominal distention. The present case is a 64-year-old male with a giant vesical diverticulum calculus. Cystolithotomy was done with primary closure of bladder, with repair of bladder diverticulum. Post-operatively, he recovered well with improved lower urinary tract function.

Giant Median Lobe Hyperplasia of the Prostate Mimicking Bladder Tumor: A Case Report

Benign prostatic hyperplasia is a common cause of bladder outlet obstruction and may cause macroscopic hematuria. Giant median lobe hyperplasia is very rare and its definition is not clear. In this case report, the diagnosis and treatment of a case with giant median lobe hyperplasia of the prostate mimicking a bladder tumor were evaluated. A 65-year-old male patient was admitted to our clinic with a 9-month history of intermittent hematuria. Abdominopelvic computed tomography revealed a mass measuring 95x85x57 mm filling the bladder. A distinct anatomical plane between the mass and the seminal vesicles could not beidentified. In the urethrocystoscopy, it was determined that the mass was the giant median lobe of the prostate. Open suprapubic prostatectomy was performed. A total of 330 g prostate tissue consisting of 180 g median lobe was enucleated. Giant median lobe hyperplasia of the prostate is a rare pathology and may mimic a bladder tumor by causing painless hematuria.

A Retrospective Operative and Early Outcome Comparison of Suprapubic Transvesical Prostatectomy and Transurethral resection of the Prostate.

BPH is the major cause of bladder outlet obstruction over the age of 40 years. Multiple surgical management options have been described of which STVP and TURP are the oldest and widely available procedures. The objective of this study is to describe and compare the intraoperative and early outcome situations of STVP and TURP. This is a hospital-based retrospective descriptive study that compares intraoperative and early outcomes of STVP and TURP in Menilik II Hospital from January 2017 to December 2019. The study samples were 72 STVP and 72 TURP patients. The mean duration of surgery in the STVP group was 97.8 minutes which is significantly longer than TURP group (66.15 minutes). Duration of post-op catheterization and hospital stay are significantly longer in STVP than TURP. The duration of surgery, length of hospital stays and post op catheterization are longer in STVP. There was no significant difference in intra-op and early complications from STVP and TURP.

PRESENTATION, MANAGEMENT, AND OUTCOME OF POSTERIOR URETHRAL VALVES IN WESTERN RAJASTHAN

Introduction: Posterior urethral valve (PUV) is the most common cause of bladder outlet obstruction and renal insufciency in male children. The aim of this study was to evaluate the presentation, management, challenges, and outcome of the disease in a Western Rajasthan tertiary health institution. Methods: In a retro-prospective study, 26 male children were included from November 2017 to March 2020 at Dr. S.N.Medical college, Jodhpur. Diagnosis was conrmed by voiding cysto-urethrography (VCUG). Results: A total of 26 patients were managed for PUV.The mean age of presentation was 3.45 years with 65.8% of the patients presenting after 1 year. Voiding dysfunction noted in 23(88.4%) patients was the most common presentation. Most common nding on physical examination was palpable bladder 15(57.6%) while UTI noted in 15 (57.6%) patients was most common complication. Abdominal sonography revealed dilated posterior urethra in 10(38.4%) cases, while VCUG revealed a dilated posterior urethra in 19 (75%) cases.The creatinine value at presentation ranged from 0.4-4.5 mg/dl with a mean of 1.10 ± 0.95 mg/dl. Valve ablation with a diathermy bugbee electrode &amp; holmium laser provided relief of obstructions in the 23 (88.4%) patients who underwent the procedure without immediate complication. The period of follow-up ranged between 1 weeks to 2 years with a mean of 8.2 months. There was sustained improvement in urine stream, reduction in the mean creatinine concentration and incidence of UTI during follow-up. Conclusion: Many patients with PUVpresented late within the reviewed period. Valve ablation provided relief of obstruction in most of the cases. Efforts at improving awareness among general population and early diagnosis and referral among the health team should be encouraged. There is a need to counsel parents on the need for long-term follow-up

PD06-06 CLINICIAN FACTORS AFFECT EXPOSURE TO RADIATION DURING VIDEO URODYNAMICS

INTRODUCTION AND OBJECTIVE:Video urodynamics (VUDS) enables delineation of site and cause of bladder outlet obstruction and/or incontinence as well as additional findings such as vesico-ureteric re...

Sonographic evaluation of bladder detrusor wall thickness among adults with benign prostatic hyperplasia In Kano, Nigeria

Background: Benign prostatic hyperplasia (BPH) is a major cause of bladder outlet obstruction due to urethral compression leading to compensatory bladder wall (Detrusor muscle) hypertrophy. Transabdominal ultrasound is a non-invasive, accessible, inexpensive method of imaging the prostate gland, the urinary bladder and its walls.Objectives: To determine and compare detrusor wall thickness in adult males with benign prostatic hyperplasia and apparently healthy males with normal sized prostate glands.Methods: It was a prospective comparative study on eighty (80) consenting adults with clinical diagnosis of BPH aged 40 – 90 years with equal number of apparently healthy matched for age asymptomatic adults. The prostate gland volumes and urinary bladder wall thickness were obtained and relationship between these parameters was analyzed at a 95% confidence interval.Results: There was a significantly higher mean (mean ± SD) bladder Detrusor thickness (DWT) among the BPH patients (2.8 ± 1.0 mm) when compared to mean (mean ± SD) DWT of normal sized prostate adults (1.6 ± 0.4 mm) (p<0.00). The mean (mean ± SD) prostate volumes for both BPH and apparently healthy adults with normal sized prostates were 57.3 ± 42.2 and 19.8 ± 3.6mls respectively (p<0.01) with the BPH patients showing significantly larger volumes. DWT was correlated with age (r2 = 0.092, p<0.01).Conclusion: The bladder wall/Detrusor wall thickness (DWT) and prostate volume were comparatively higher in subjects with BPH than in apparently healthy individuals with normal prostates. Also DWT significantly correlated with prostate volume.Keywords: Ultrasonography, urinary tract, compliance, bladder outlet obstruction