Clinical Implications of Residual Urine in Korean Benign Prostatic Hyperplasia (BPH) Patients: A Prognostic Factor for BPH-Related Clinical Events.
OBJECTIVE
Although post-void residual urine (PVR) is frequently utilized clinically in patients with benign prostatic hyperplasia (BPH), mainly because of its procedural simplicity, its role as a clinical prognostic factor, predictive of treatment goals, is still under much dispute. We investigated the predictive value of PVR for BPH-related clinical events including surgery, acute urinary retention (AUR), and admission following urinary tract infection (UTI).


METHODS
From January to June of 2006, patients over 50 years of age who were diagnosed with BPH for the first time at the outpatient clinic and were then treated for at least 3 years with medications were enrolled in this study. The variables of patients who underwent surgical intervention for BPH, had occurrences of AUR, or required admission due to UTI (Group 1, n=43) were compared with those of patients who were maintained with medications only (Group 2, n=266).


RESULTS
Group 1 had a significantly higher PVR, more severe symptoms, and a larger prostate at the time of the initial diagnosis in both the univariate and the multivariate analysis. In the 39 patients who underwent BPH-related surgery, although there was a significant change in Qmax at the time of surgery (mean, 13.1 months), PVR and the symptom score remained unchanged compared with the initial evaluation. In the receiver-operating characteristic curve analysis, the area under the curve of Group 1 was in the order of prostate volume (0.834), PVR (0.712), and symptom score (0.621). When redivided by arbitrarily selected PVR cutoffs of 50 mL, 100 mL, and 150 mL, the relative risk of clinical BPH progression was measured as 3.93, 2.61, and 2.11.


CONCLUSIONS
These data indicate that, in the symptomatic Korean population, increased PVR at baseline is a significant indicator of BPH-related clinical events along with increased symptom score or prostate volume.
Department of Urology, Korea University School of Medicine, Seoul, Korea.
Young Hwii
YH
Ko
Ji Yun
JY
Chae
Seung Min
SM
Jeong
Jae Il
JI
Kang
Hong Jae
HJ
Ahn
Hyung Woo
HW
Kim
Sung Gu
SG
Kang
Hoon Ah
HA
Jang
Jun
J
Cheon
Je Jong
JJ
Kim
Jeong Gu
JG
Lee
Br J Urol. 1994 Nov;74(5):566-71
7530119
Urology. 2003 Oct;62(4):667-71
14550440
Tech Urol. 2000 Mar;6(1):26-8
10708144
Urology. 1988 May;31(5):445-9
3284155
J Urol. 1999 Jan;161(1):122-7
10037383
J Urol. 2006 Apr;175(4):1422-6; discussion 1426-7
16516013
J Urol. 1997 Jul;158(1):59-61
9186323
J Urol. 2009 Feb;181(2):710-6
19091352
Br J Urol. 1988 Dec;62(6):571-5
2464395
Urology. 1999 Jul;54(1):90-6
10414733
World J Urol. 1995;13(1):17-20
7539676
J Urol. 2007 Apr;177(4):1395-400; quiz 1591
17382740
J Urol. 1992 Dec;148(6):1856-60
1433620
Br J Urol. 1981 Dec;53(6):613-6
6172172
Scand J Urol Nephrol. 1996 Apr;30(2):89-91
8738051
Int J Urol. 2009 Sep;16(9):739-44
19659551
J Clin Endocrinol Metab. 1999 Oct;84(10):3613-9
10523004
Br J Urol. 1995 Mar;75(3):347-53
7537604
Asian J Androl. 2002 Dec;4(4):269-71
12508127
BJU Int. 2006 Apr;97 Suppl 2:12-5; discussion 21-2
16507047
J Urol. 1993 Aug;150(2 Pt 1):351-8
7686980
J Urol. 1979 May;121(5):551-4
571479
Urol Nurs. 1994 Jun;14(2):37
7535950
Urology. 2005 Aug;66(2):316-22
16098361
Urology. 1982 Dec;20(6):602-4
7179626