title: Prostatic urethral angulation associated with urinary flow rate and urinary symptom scores in men with lower urinary tract symptoms.
abstract: OBJECTIVE
  To evaluate the effect of the prostatic urethral angle (PUA) on the peak flow rate (Qmax) and urinary symptoms in the clinical setting.
  
  
  METHODS
  The records were obtained from a prospectively maintained database for first-visit men with lower urinary tract symptoms. Uroflowmetric measurements, postvoid residual urine volume, and International Prostate Symptom Score were assessed. The prostate-related parameters, including prostate volume, PUA, and intravesical prostatic protrusion, were measured using transrectal ultrasonography. Patients with comorbidities that can affect voiding function or in whom the PUA could not be measured were excluded.
  
  
  RESULTS
  A total of 316 patients were included. On multivariate linear regression analysis, the PUA (P = .002) was independently associated with the International Prostate Symptom Score. However, the International Prostate Symptom Score was not influenced by patient age, prostate volume, or intravesical prostatic protrusion. The mean PUA was significantly different according to symptom severity. The mean PUA was 42.2° ± 7.0°, 45.5° ± 9.1°, and 47.3° ± 8.6° in patients with mild, moderate, and severe symptoms, respectively (P = .004, analysis of variance). Although the PUA (P <.001) and patient age (P <.001) were independent predictors of Qmax, the prostate volume and intravesical prostatic protrusion did not affect the Qmax. The mean PUA was 52.2° ± 7.3° in patients with a Qmax <10 mL/s, 45.0° ± 7.9° in those with a Qmax ≥10 mL/s but <20 mL/s, and 39.8° ± 7.9° in those with a Qmax of ≥20 mL/s (P <.001, analysis of variance).
  
  
  CONCLUSIONS
  The results of our study has shown that the PUA is significantly associated with the Qmax and symptom scores in men with lower urinary tract symptoms. Our findings suggest that the PUA should be considered in the treatment of male patients with lower urinary tract symptoms.
authors.affiliation: Department of Urology, Hallym University College of Medicine, Chuncheon, Korea.
authors.forename: Woo Jin
authors.initials: WJ
authors.lastname: Bang
authors.forename: Hong Wook
authors.initials: HW
authors.lastname: Kim
authors.forename: Joo Yong
authors.initials: JY
authors.lastname: Lee
authors.forename: Dae Hoon
authors.initials: DH
authors.lastname: Lee
authors.forename: Yoon Soo
authors.initials: YS
authors.lastname: Hah
authors.forename: Hyung Ho
authors.initials: HH
authors.lastname: Lee
authors.forename: Kyo Chul
authors.initials: KC
authors.lastname: Koo
authors.forename: Ho Song
authors.initials: HS
authors.lastname: Yu
authors.forename: Won Sik
authors.initials: WS
authors.lastname: Ham
authors.forename: Kang Su
authors.initials: KS
authors.lastname: Cho
mesh_terms: D000368:Aged; D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000473:pathology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D014521:Urethra / Q000473:pathology*; D014563:Urodynamics