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Peak Flow Rate (peak + flow_rate)
Selected AbstractsLong-term results of three different minimally invasive therapies for lower urinary tract symptoms due to benign prostatic hyperplasia: Comparison at a single instituteINTERNATIONAL JOURNAL OF UROLOGY, Issue 4 2007Takashi Ohigashi Objective: We analyzed the efficacy and durability of three different minimally invasive therapies (MIT) for lower urinary symptoms performed at a single institution based on a 5-year prospective cohort study. Methods: The pre- and postoperative evaluation was made in 103 patients with the following three MIT options: (i) transurethral microwave thermotherapy (TUMT, n = 34); (ii) transurethral needle ablation (TUNA, n = 29); and (iii) transrectal high intensity focused ultrasound (HIFU, n = 40). Results: All three treatments significantly improved the symptom scores up to 2 years after treatment. However, no statistical difference was observed in the efficacy between MIT. The percentage of men requiring the secondary treatment also showed no statistical differences. Cox's proportional hazards multivariate regression model revealed the baseline peak flow rate (Qmax) and total International Prostate Symptom Score (IPSS) but the types of MIT are independent significant factors for determining the long-term clinical results of MIT. Conclusion: Our data showed no statistical differences in either the efficacy or in the durability between the three MIT. The baseline Qmax and total IPSS are the significant factors for determining the long-term results of MIT. [source] Urodynamic findings in female diabetic patients with and without overactive bladder symptoms,,NEUROUROLOGY AND URODYNAMICS, Issue 3 2010Chen-Hsun Ho Abstract Aims The purpose was to analyze urodynamic findings in female diabetic patients with OAB symptoms. Methods Data from 94 female diabetic patients who underwent urodynamic studies in evaluation of various LUTS were retrospectively reviewed. Urodynamic findings, demographic data, and clinical symptoms were compared between patients with and without OAB. Results Among the 94 subjects analyzed, 34 (36.2%) were diagnosed as OAB. Demographic data were similar between the patients with and without OAB. In the OAB group, patients had significantly higher storage symptom scores and marginally higher voiding symptom scores. On cystometry, the OAB group had a higher percentage of increased bladder sensation (41.2% vs 11.7%, P,=,0.001) and detrusor overactivity (29.4% vs 10.0%, P,=,0.023). The OAB group had lower peak flow rate (16.2,±,5.9 vs 19.3,±,6.3 ml/s, P,=,0.023), greater PVR volume (60.3,±,29.4 vs 45.0,±,25.1 ml, P,=,0.009), and lower bladder voiding efficiency (BVE, 75.2,±,2.8 vs 81.5,±,2.9%, P,<,0.001). On pressure-flow studies, the OAB group had a higher percentage of BOO (26.5% vs 6.7%, P,=,0.008). Conclusions Our study shows that the most frequent urodynamic finding of OAB in female diabetic patients is increased bladder sensation, followed by detrusor overactivity. Compared to those without OAB, female diabetic patients with OAB are more likely to have impaired voiding function, characterized by lower peak flow rate, greater PVR volume, lower BVE, and a higher percentage of BOO. In these patients, BOO not only causes voiding difficulty but may also contribute to the development of OAB. Neurourol. Urodynam. 29:424,427, 2010. © 2009 Wiley-Liss, Inc. [source] Why do women have voiding dysfunction and de novo detrusor instability after colposuspension?BJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 4 2002L. Bombieri Objective To investigate the causes of voiding dysfunction and new detrusor instability after colposuspension. Design Prospective, observational study. Setting Urogynaecology unit, district general hospital. Population Seventy-seven women undergoing colposuspension for genuine stress incontinence. Methods The following factors were investigated: 1. bladder neck elevation by magnetic resonance imaging before and after surgery; 2. urethral compression by measuring bladder neck approximation to the pubis with magnetic resonance imaging after surgery (anterior compression) and the distance between the medial stitches during surgery (lateral compression); 3. clinical and urodynamic factors. Main outcome measures 1. Post-operative voiding function (i.e. first day of voiding and day of catheter removal); 2. objective evidence of detrusor instability three months post-operatively. Results Pre-operative peak flow rate (P= 0.004), straining during voiding (P= 0.005), increasing age (P< 0.001), operative elevation (P< 0.001) and anterior urethral compression (P= 0.001) were associated with the number of days of post-operative catheterisation. Increasing age (P= 0.02), previous bladder neck surgery (P= 0.04), operative elevation (P= 0.049) and anterior urethral compression (P< 0.001) were associated with detrusor instability at three months. Conclusion Surgical factors (bladder neck elevation and compression) are associated with voiding dysfunction and detrusor instability after colposuspension. These findings have implications for prevention. [source] Updated meta-analysis of clinical trials of Serenoa repens extract in the treatment of symptomatic benign prostatic hyperplasiaBJU INTERNATIONAL, Issue 6 2004P. Boyle OBJECTIVES To determine, by analysing all available clinical trial data, the clinical efficacy against placebo of an extract from the fruit of the American dwarf palm tree, Serenoa repens (Permixon®, Pierre Fabre Médicament, Castres, France), as there is controversy about the use of phytotherapeutic agents in men with lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH). METHODS All clinical trial data published on Permixon, comprising 14 randomized clinical trials and three open-label trials, involving 4280 patients, were analysed. These trials were of different size (22,1100 patients) and duration (21,720 days). The peak urinary flow rate and nocturia were the two common endpoints. The statistical analysis was based on a random-effects meta-analysis. RESULTS Permixon was associated with a mean (sem) reduction in the International Prostate Symptom Score (IPSS) of 4.78 (0.41). The mean placebo effect on peak urinary flow rate was an increase of 1.20 (0.49) mL/s. The estimated effect of Permixon was a further increase of 1.02 (0.50) mL/s (P = 0.042). Placebo was associated with a reduction in the mean number of nocturnal voids of 0.63 (0.14); there was a further reduction attributable to Permixon of 0.38 (0.07) (P < 0.001). There was some heterogeneity among the studies for nocturia; one over 2 years involving 396 patients and showing no difference between placebo and Permixon had a large effect on the results. CONCLUSIONS This meta-analysis of all available published trials of Permixon for treating men with BPH showed a significant improvement in peak flow rate and reduction in nocturia above placebo, and a 5-point reduction in the IPSS. [source] Rotoresect for bloodless transurethral resection of the prostate: a 4-year follow-upBJU INTERNATIONAL, Issue 1 2003M.S. Michel OBJECTIVE To report the results and long-term follow-up of transurethral resection of the prostate (TURP) with a new resection device, the Rotoresect (Karl Storz, Tuttlingen, Germany). PATIENTS AND METHODS Most endoscopic resection techniques for benign prostatic tissue aim for high ablation rates and minimal bleeding. Available resection electrodes are effective, but cause high blood loss (loop electrode), or less bleeding but poorer ablation rates (electrovaporization). To resolve these conflicts the Rotoresect was developed in 1995; it consists of a specially designed rotating resection electrode, driven by a micromotor, and a high-frequency current to enable simultaneous coagulation, vaporization and mechanical tissue removal during resection. To date, 84 patients with benign prostatic hyperplasia have had their prostate resected with this device (mean prostate size 46.0, sd 18.4 mL) and have been assessed for up to 4 years. RESULTS During resection there was very little bleeding, with no significant changes in haemoglobin or sodium levels. The mean (sd) duration of catheterization was 1.4 (1.1) days; the urinary peak flow rate was improved from 9.7 (3.2) to 24.2 (8.23) mL/s and the residual urine volume reduced from 187.3 (109.6) to 22.7 (19.5) mL. The International Prostate Symptom Score and quality-of-life index were both improved, from 24.0 (7.5) to 4.1 (2.7), and 4.2 (3.2) to 0.8 (0.9), respectively. Overall the results were stable during the 4 years of follow-up. CONCLUSION The Rotoresect combines the advantages of standard resection (high ablation rate) by actively rotating the resection electrode, and the haemostatic effect of electrovaporization (minimal blood loss) by simultaneous tissue coagulation and vaporization. [source] A prospective study of conservatively managed acute urinary retention: prostate size mattersBJU INTERNATIONAL, Issue 7 2000V. Kumar Objective To evaluate in a prospective study the medium- to long-term outcome of a policy of conservatively managing acute urinary retention (AUR), arising solely by bladder outlet obstruction caused by benign prostatic enlargement (BPE), and to identify the factors favouring a positive outcome of a trial without catheter (TWOC). Patients and methods All men admitted as an emergency with primary AUR caused by BPE (from August 1997 to March 2000) underwent a TWOC. The following variables were recorded; the nature and duration of any preceding lower urinary tract symptoms, previous episodes of retention, concomitant anticholinergic medication, coexisting constipation, alcohol as a precipitating cause of AUR, previous prostatectomy, confirmed urinary tract infection, residual urine drained on catheterization and prostate size, as determined by a digital rectal examination (DRE) carried out by one consultant urologist in all patients. Those voiding successfully were followed up prospectively using the International Prostate Symptom Score (IPSS), quality-of-life score, urinary flow rate measurement and ultrasonographic measurement of the postvoid residual (PVR). Results Of the 40 men with AUR, 22 (55%) voided spontaneously after removing the catheter and continued to do so with mean peak flow rates of 12.2 mL/s and mean PVRs of 69.6 mL over a follow-up of 8,24 months. These patients remained asymptomatic, with a mean IPSS of 5.2 and quality-of-life score of 0.9. These men had a mean prostatic size of 15.9 g and a mean catheterized residual volume of 814 mL, while in those who had an unsuccessful TWOC the mean prostate size was 27.5 g (P = 0.006) and a mean catheterized residual volume of 1062 mL (P = 0.09). Prostate size as assessed by the DRE was the most significant factor in predicting the outcome of a TWOC. Conclusion A TWOC is justified in the long-term for men presenting with AUR caused by BPE. Prostate size is the most important factor for predicting the outcome of such a trial. [source] | ||||||||||