title: Can Bladder and Prostate Sonomorphology Be Used for Detecting Bladder Outlet Obstruction in Patients With Symptomatic Benign Prostatic Hyperplasia?
abstract: OBJECTIVE
  To investigate the accuracy of the bladder and prostate sonomorphologic parameters for the diagnosis of bladder outlet obstruction (BOO) in patients with lower urinary tract symptoms (LUTS)/benign prostatic hyperplasia (BPH).
  
  
  METHODS
  First-visit men, aged ≥ 50 years, with LUTS/BPH were prospectively enrolled. Added to the initial basic evaluation, all patients underwent pelvic ultrasonography and pressure flow study. The pressure flow study was used as a reference standard for BOO, and according to its results, patients were divided into BOO and non-BOO groups. The sonomorphologic findings were compared between both groups, and the diagnostic accuracy of the significant parameters was determined.
  
  
  RESULTS
  In total, 157 patients were included. Of these, 48 (30.57%) had BOO and 109 (69.43%) did not. Bladder wall thickness (BWT), ultrasound estimated bladder weight (UEBW), and intravesical prostatic protrusion (IPP) were the sonomorphologic parameters that differed significantly between both groups (P < .001). By receiver operating characteristic curve analysis, the optimal cutoff values distinguishing patients with BOO were BWT of 3.7 mm (area under the curve [AUC]: 0.940), UEBW of 31.5 g (AUC: 0.835), and IPP of 10.9 mm (AUC: 0.874). The sensitivity, specificity, and accuracy of BWT, UEBW, and IPP were 95.00%, 90.91%, and 93.55%; 75.44, 57.97%, and 65.62%; and 87.90%, 76.43%, and 82.17%, respectively.
  
  
  CONCLUSIONS
  BWT, UEBW, and IPP measurements can be used to detect BOO in LUTS/BPH patients. The simple estimation of these sonomorphologic parameters by suprapubic approach makes these measurements potentially suitable methods to judge BOO noninvasively during the routine clinical evaluation of BPH.
authors: Department of Urology, Prince Sattam bin Abdulaziz University, Al-Kharj, Saudi Arabia; Department of Urology, Al-Azhar University, Cairo, Egypt. Electronic address: abulfotouhahmed@yahoo.com.
authors: Abul-Fotouh
authors: AF
authors: Ahmed
authors: Department of Diagnostic Radiology, Prince Sattam bin Abdulaziz University, Al-Kharj, Saudi Arabia.
authors: Mohamed
authors: M
authors: Bedewi
mesh_terms: D000368:Aged; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011470:Prostatic Hyperplasia / Q000150:complications* / Q000175:diagnosis; D012372:ROC Curve; D012189:Retrospective Studies; D014463:Ultrasonography; D001743:Urinary Bladder / Q000000981:diagnostic imaging*; D001748:Urinary Bladder Neck Obstruction / Q000175:diagnosis* / Q000209:etiology