Introduction: We previously developed a noninvasive video urodynamic study using color Doppler ultrasonography. We sought the best flow velocity-related parameter which would allow prediction of an improvement in lower urinary tract symptoms (LUTS) after α1-blocker treatment. Methods: Twenty-two men with benign prostatic hyperplasia who were treated with a nonselective α1-blocker (urapidil) were included. Subjective symptoms were evaluated using the International Prostate Symptom Score (IPSS) before and after α1-blocker treatment. We measured the flow velocities using a transperineal ultrasound technique in the distal prostatic urethra just proximal to the external urethral sphincter (V1) and in the sphincteric urethra (V2), and used them to obtain the velocity ratio (VR = V1/V2). The corresponding functional cross-sectional areas of the urethra at these two sites (A1 and A2) were calculated as Qmax/V. All these parameters obtained by the velocity-flow urodynamics were compared before treatment and after 4 weeks. Results: After treatment, V1 and VR were decreased, and A1 was increased. V2 correlated best with the change in IPSS before and after α1-blocker therapy, with Spearman’s rho of 0.584. All men with V2 exceeding 50 cm/s did not show an improvement in the LUTS. Conclusions: The maximum flow velocity at the sphincteric urethra (V2) can predict the subjective outcome of α1-blocker treatment. The velocity-flow parameters changed after α1-blocker treatment. We confirmed that the transperineal ultrasound urodynamic study is not only noninvasive but also informative.

Keywords:
Urodynamics, Doppler ultrasonography, Adrenergic α-blocker, Benign prostatic hyperplasia
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© 2004 S. Karger AG, Basel
2004
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