Detrusor Muscle Thickness and Prostate Volume in the Diagnosis of Bladder Outlet Obstruction

Abstract

Introduction: Bladder outlet obstruction (BOO) is a common diagnosis and it is reported to be the most common urological problem of elderly male patients which can lead to detrusor instability in 50% to 70% of men with benign prostatic hyperplasia. This study aimed to determine the relationship between detrusor muscle thickness, prostate volume, and International Prostate Symptom Score [IPSS] in patients with BOO using ultrasound. Methods: This is a prospective, descriptive comparative sonographic evaluation of the detrusor muscle thickness in participants with BOO using IPSS as a gold standard. Results: The most frequent age group with BOO was 60 – 69 years 32[32%] subjects. IPSS score distribution showed mild in 17 [17%] subjects, moderate in 78 subjects [78%], and severe in 5 subjects [5%] in the BOO group.  The control group showed that 100 [100%] subjects fell within the mild score category. Statistical significance was a p-value of 0.000. Moderate and severe IPSS showed p- value of 0.006. Association between IPSS and DWT showed a value of 0.675, Association between IPSS and prostate volume had a value of 0.657, and association between DWT and Prostate volume had a value of 0.787. DWT and prostate volume each had sensitivity, NPV, and PPV of 52%, 0.53, and 0.51 for BWT and 59%, 0.63, and 0.56 for prostate volume respectively.  Both parameters also showed low specificity of 48% for DWT and 44% for prostate volume. Both parametres show sensitivity of 52% for DWT and 59% for prostate volume. Conclusion: Sonographic measurement of BWT is a good tool in the assessment of BOO.