title: Usefulness of bladder-prostate ultrasound in the diagnosis of obstruction/hyperactivity in males with BPH.
abstract: OBJECTIVE
  To determine the utility of prostate ultrasound in the diagnosis of infravesical obstruction (IVO) and detrusor hyperactivity(DH).
  
  
  METHODS
  Prospective study with 39 patients consulting for LUTS. Clinical history was compiled, IPSS was determined, a digital rectal exam was  performed, abdominal ultrasound was used to calculate detrusor thickness/weight, prostate volume, and middle lobe length (MLL). Urodynamic study  (UD) was  performed with determination of the Abrams-Griffiths number and ICS nomogram. Mean values were compared with Mann-Whitney U-test,  and ROC curves were  plotted determining the cutoff points for optimum sensitivity/specificity.
  
  
  RESULTS
  Mean age was 63.1 years (SD: 7.8), with a mean IPSS score of 14 (SD: 6). 53.8% of the patients presented IVO at UD  evaluation, and  43.6% DH.  The differences between free flowmetry Qmax(p=0.015) and MLL (p=0.003) between patients with and without IVO proved  significant. The ROC curves  yielded  an AUC for middle lobe length of 0.772, with a maximum sensitivity and specificity cutoff point at 10.5 mm (sensitivity 90%, specificity  73%,  PPV 76%, NPV 85%). There were no significant differences in any parameter between patients with and without DH.
  
  
  CONCLUSIONS
  Ultrasound MLL measurement in patients with LUTS offers high sensitivity/specificity in diagnosing IVO, with a cutoff point of 10.5 mm.  In our study it wasn't effective in the noninvasive diagnosis of DH.
authors.affiliation: Urology Department, Hospital Universitario and Politécnico La Fe, Valencia, España. edumoran@comv.es
authors.forename: Eduardo Moran
authors.initials: EM
authors.lastname: Pascual
authors.forename: Alba
authors.initials: A
authors.lastname: Polo
authors.forename: Gonzalo
authors.initials: G
authors.lastname: Morales
authors.forename: Ana
authors.initials: A
authors.lastname: Soto
authors.forename: Ramón
authors.initials: R
authors.lastname: Rogel
authors.forename: Gonzalo
authors.initials: G
authors.lastname: García
authors.forename: Salvador
authors.initials: S
authors.lastname: Arlandis
authors.forename: Enrique
authors.initials: E
authors.lastname: Broseta
authors.forename: Juan Fernando
authors.initials: JF
authors.lastname: Jiménez-Cruz
mesh_terms: D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011467:Prostate / Q000000981:diagnostic imaging*; D011470:Prostatic Hyperplasia / Q000150:complications; D012680:Sensitivity and Specificity; D014463:Ultrasonography; D001743:Urinary Bladder / Q000000981:diagnostic imaging*; D001748:Urinary Bladder Neck Obstruction / Q000150:complications / Q000000981:diagnostic imaging*; D053201:Urinary Bladder, Overactive / Q000150:complications / Q000000981:diagnostic imaging*