| Co-Investigator(Kenkyū-buntansha) |
YAMANISHI Tomonori Dokkyo University School of Medicine, Urology, Lecturer, 医学部, 講師 (90220425)
YANO Masataka Dokkyo University School of Medicine, Urology, Instructor, 医学部, 助手 (30281299)
KITAHARA Satoshi Dokkyo University School of Medicine, Urology, Associate Professor, 医学部, 助教授 (10186257)
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| Research Abstract |
With benign prostatic hyperplasia (BPH), lower urinry tract symptoms, such as retardation and nocturia, are associated. WHO recommends to score the seven specified symptoms (IPSS) for grading the severity of BPH. IPSS is useful to evaluate the clinical outcomes of many kinds of therapy on BPH in the same patients. However, it has been proved that IPSS does not reflect the extent to which the prostate is enlarged or to which the lower urinary tract is obstructed. In short, IPSS is not a well-established diagnostic scale. We have perfomed urodynamnic testings in detail and found characteristic urodynamic findings in BPH and studied the relationship between such findings and lower urinary tract symptoms which are commonly found in BPH.
We have made, from the results of our series of urodynamic studies, a scoring scale for BPH (SPSS). Using this scale in 30 cases of BPH, we studied differences between IPSS and SPSS from the standpoint of age, prostate volume (as measured on echogram), uroflowmetry, pressure/flow study, A-G nomogram, Schaefer's obstruction prameters and residual urine volume.
The maximum flow rate (Q max) and the average flow rate (Q ave) were found correlating significantly with SPSS, but not with IPSS. This proves that SPSS reflects urodynamic conditions, or objective findings, more than IPSS. Neither SPSS nor IPSS was related with Schaefer's obstruction parameters or A-G nomogram. These two scales were not correlated with total prostate volume and adenoma volume. There was a correlation between A-G nonmogram or Schaefer's nomograim and total prostate volume. This means that the lower urinary tract is obstructed by prostatic enlorgement. However, it remains to be explained why SPSS was correlated with uroflowmetric parameters, but not with obstraction parameters.
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