目的：本研究在於分析前列腺體積測量與錄影尿動力學在診斷良性前列腺肥大併下尿路症狀男性在膀胱出口阻塞程度之關係。材料與方法：本回溯性研究共有569位具有良性前列腺肥大併下尿路症狀男性接受了經直腸前列腺超音波及錄影尿動力檢查。全部病人都符合具有總前列腺體積20毫升以上以及國際前列腺症狀積分 (International Prostate Symptom Score) 8分以上的條件。病人根據錄影尿動力學及AG數(Abrams-Griffiths number)的結果分成膀胱出口阻塞組與非膀胱出口阻塞組並在這分組間分析總前列腺體積、移形區指數 (transition zone index) 與膀胱出口阻塞程度之間的相互關係。結果：根據錄影尿動力學檢查結果顯示有436位男性分為膀胱出口阻塞組 (BOO), 133位為非膀胱出口阻塞組 (non-BOO)。BOO與non-BOO組的平均年齡分別是70.4 ± 8.7 and 68.9 ± 9.7歲。病人在總前列腺體積≥20，≥30，以及≥40ml的膀胱出口阻塞盛行率分別為76.3%,82.3%以及92.0%；而在移形區指數≥0.3，≥0.4以及≥0.5的膀胱出口阻塞盛行率分別為79.5%,86.9%以及89.9%。經直腸前列腺超音波得出的總前列腺體積與移形區指數在B00與non-B00組分別為36.9 ± 18.5, 29.7 ± 10.5ml；以及0.46 ± 0.14, 0.36 ± 0.10 (p<0.05)。經由AG數的增加來定義膀胱出口阻塞程度，在有膀胱出口阻塞的病人中總前列腺體積的增加會與膀胱出口阻塞程度的增加有關 (r=0.20, p<0.0001)但是在沒有膀胱出口阻塞的病人中則沒有這種現象(r=0.0107, p=0.17)。在BOO組當中，膀胱出口阻塞程度與移形區指數 ≥ 0.5時則有顯著地差異 (r=0.153, p=0.046)。結論：在有前列腺肥大合併有下尿路症狀的老年男性當中, 膀胱出口阻塞程度與藉由經直腸前列腺超音波所測量出的總前列腺體積與移形區指數有顯著的相關性。移形區指數比起總前列腺體積在有前列腺肥大的病人在膀胱出口阻塞程度上能夠有更強的臆測能力。

OBJECTIVE: To analyze the relationship between prostatic volume measurement and the videourodynamic diagnosis of degree of bladder outlet obstruction (BOO) in men with benign prostatic hyperplasia (BPH) and lower urinary tract symptoms (LUTS).MATERIALS AND METHODS: Transrectal sonography of the prostate (TRUS-P) and a videourodynamic study (VUDS) were performed in 569 men with BPH and LUTS. All patients had a total prostatic volume (TPV) of ≥ 20 ml and an International Prostate Symptom Score (IPSS) of ≥8 points. The patients were assigned to BOO and non-BOO groups according to the results of VUDS and the Abrams-Griffiths number (AG number). Correlation of TPV, and the transition zone index (TZI) with the degree of BOO were retrospectively analyzed in patients with and those without BOO.RESULTS: VUDS results revealed that 436 men had BOO and 133 men did not. The mean ages were 70.4 ± 8.7 and 68.9 ± 9.7 years in the BOO and non-BOO groups, respectively. The incidences of BOO in patients with TPV of ≥20, ≥30, and ≥40 ml were 76.3%, 82.3%, and 92.0%, respectively. The incidences of BOO in patients with TZI values of ≥0.3, ≥0.4 and ≥0.5 were 79.5%, 86.9%, and 89.9%, respectively. The results of TRUS-P revealed that the means of TPV and TZI values were 36.9±18.5 ml and 0.46±0.14 in the BOO group; and 29.7±10.5 ml and 0.36±0.10 in the non-BOO group, respectively (both p＜0.05). According to the degree of BOO as defined by the increment in the AG number, an increased TPV correlated well with the increased degree of BOO in patients with BOO (r=0.20, p＜0.0001), but not in the non-BOO group (r=0.12, p=0.17). The same results were found with TZI values and the degree of BOO in patients with BOO (r=0.22, p＜0.0001), but not in the non-BOO group (r=0.03, p=0.75). The correlation of the degree of BOO and a TPV of ≥40 ml in the BOO group was not significant (r=0.107, p= 0.211), whereas the correlation of the degree of BOO and TZI value of 0.5 in the BOO group was significant (r=0.153, p=0.046).CONCLUSIONS: In elderly men with BPH and LUTS, the degree of BOO was significantly correlated with TPV and TZI values as measured by TRUS-P. The association of the TZI with the degree of BOO was stronger than the TPV in determing the degree of BOO in BPH patients.