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KMID : 0358319960370070779
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Korean Journal of Urology
1996 Volume.37 No. 7 p.779 ~ p.782
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Maximum Detrusor Pressure Measurement by Eyeball Urodynamic Study in the Diagnosis and Postoperative Follow-up in BPH
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Abstract
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It is known that the diagnostic accuracy is about 75% by conventional melthod without pressure/flow study in BPH. But we cannot apply the pressure/flow study to the every patient in the diakgnosis of BPH due to high cost of epqipment and
invasivenss of
the study.
Genkerally, in compensatory phase with obstruction, we can diaagnose obstruction easily because maximum urine flow rate is decreased and maximum intravestical pressure is high. But in decompensaftory phase with obstruction we must perform
invasive
pressure/flow study to differentiate obstruction from the patient with decreased detrusor contractility without obstruction because urine flow rate is sdecreased and maximum intravesical pressure is low in both cases.
We diagnosed obstruction if the maximum flow rate is lower than 15 ml/sec kand the maximum intravesical pressure is higher than 50 cm H2O by eyeball urodynamic study and if URA is higher than 29 cm H2O by invasive pressure/flow study in the
patient
whose maximum flow rate is lowere than 15 cc/sec with less that 50 cm H2O of maximum intravesical pressfure by eveball urodynamic study.
We diagnosed 141 kBPH patientsw in which 116 (82.3%) patients by eyeball urodynamic study and 25 (17.7%) patients by pressure/flow study and treated them bys open prostatectomy or TURP.
Symptoms were improved in 120 (83%) patients within 3 months. Ten (8.0%) out of 21 (17%) paktients swhose symptoms were not improved after 3 months with higher than 15 mlj/sec of maximum flow rate were diagnosed as increased detrusor
contractility.
Eyeball urodynamic study was performed in the other 11 (8.9%) patients with lower than 15 ml/sec of maximum flow rate.
Six (4.8%) of them were diagnosed as decreased detrusor contractility due to lower than 50 cm H2O of maximum intravesicald pressure and the other 5 (4.0%) were diagnosed as obstruction due to higher than 50 cm H2O of maximum intravesicla pressure
in
eyeball urodynamic study. Five (4.0%) patients had urina5ry incontinence. Four (3.2%) out of them had increased detrusor contractility and the other one had obstruction.
Alpha blockers or anticholinergics were applied in the patient with increased detrusor contractility, CIC or Foley catheter was indwelled in the patients with decreased detrusor contractility. Repeated TURP or urethral dilation was aplied to the
patient
with obstruction. After all symptoms were improved in all patients except 3 (2.4%).
In conclusion maximum detrusor pressure measurement with eyeball urodynamic study is very useful and less sophisticated method in the diagnosis and postoperative follow-up in BPH.
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