The Importance of Residual Urine Measured After the Second Miction in The Evaluation of Benign Prostatic Hyperplasia Patients with Lower Urinary Tract Symptoms
Erdal Karavas1, Erkan Hirik21Department of Radiology, Erzincan Binali Yıldırım University Faculty of Medicine, Erzincan, Turkey, 2Departments of Urology, Erzincan Binali Yıldırım University Faculty of Medicine, Erzincan, Turkey
Objectives: Examine the correlation between the results of bladder voiding after uroflowmetry (PVR1) and second voiding (PVR2), and to investigate the factors affecting this in patients presented with lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH). Methods: The study included fifty-five male patients presented to the urology outpatient clinic with LUTS and followed up with the diagnosis of BPH. The study was designed as self-controlled and prospective. All patients' medical records were taken and physical examinations, biochemistry, PSA tests and urinalysis were performed. Patients with diseases other than BPH were excluded from the study. Ultrasound (US) of the urinary tract was started when the patients felt the first urge to urinate. The size of prostate gland was measured from the dimensions. Immediately after bladder voiding on uroflowmetry device following the examination, PVR1 was measured using US. Following the measurement, the patient was kept waiting for five minutes and PVR2 was measured again with US immediately after the second bladder voiding. A PVR of ?50 mL was considered as residual urine. Results: The difference between PVR1 and PVR2 was statistically significant (p<0.001). Moreover, the PVR1 results of ?50 mL reduced under 50 mL in 38.2% of the patients in PVR2 (p<0.001). The difference obtained by subtracting PVR2 volume from PVR1 volume was positively correlated with the total volume of urine (p<0.001, r=0.57). There was a statistically significant difference in the total volume of urine (p=0.001) in the grouping by considering 50 mL as the limit in PVR1 and PVR2. There was a weak negative correlation between Qmax and PVR1 (p=0.005, r=-0.37) and PVR2 (p=0.001, r=-0.45). The patients with a PVR2 value of 50 mL or higher had a statistically lower Qmax value than the patients with a PVR2 value below 50 mL (p=0.002), but there was no significant difference with the PVR1 of the same equation (p=0.084). Conclusion: In the evaluation of the patients with the diagnosis of BPH with LUTS, we are of the opinion that the patient should be managed by considering the PVR value measured following the second voiding of the patient after routine uroflowmetry. Benign prostatic hyperplasia, lower urinary tract symptoms, measurement, postvoiding residual volume, ultrasonography
Cite This Article
Karavas E, Hirik E. The Importance of Residual Urine Measured After the Second Miction in The Evaluation of Benign Prostatic Hyperplasia Patients with Lower Urinary Tract Symptoms. EJMI. 2019; 3(2): 95-99
Corresponding Author: Erdal Karavas