Correlation Study Of The Volume Measurement Parameters Of Each Part Of The Three Dimensional Model Of The Prostate And The Results Of The Urinary Dynamics

Objective: By using software to establish magnetic resonance imaging(MRI)three-dimensional model of prostate,we make correlation analysis between the volume-related index of each part and urodynamic results,and study its difference of diagnosing bladder outlet obstruction(BOO),which can provide reference evidence for the patients of benign prostatic hyperplasia(BPH)to anticipate efficacy in the pre-operation and timing of surgery and removal of key obstruction during operation to service for the majority of patients.Materials and methods: 30 cases of BPH were 72.73±1.673 years old.Resulting from lower urinary tract symptoms,they were hospitalized and treated,except for the diseases of urinary system infection,bladder stones,prostate cancer,urethral stricture,bladder of nerve source sex etc.All patients have certain degrees of intravesical prostatic protrusion and have finished prostate MRI and urodynamic examinations.Before which serum PSA determination was done.We import the prostate MRI pictures of all patients into MITK software to complete three-dimensional image reconstruction of prostate,which can get total prostate volume.Besides,we can also divide the prostate into several parts and obtain each part's volume according to the principle of anatomy combining with prostate MRI imaging characteristics.By this method,we can acquire the following data: total prostate volume(TPV)?the left transitional zone volume(TZV-L)?the right transitional zone volume(TZV-R)?peripheral zone volume(PZV)?intravesical prostatic protrusion volume(IPPV)?intravesical prostatic index(IPPV /TPV)?transitional zone index(TZV/TPV)?and the difference of absolute value of bilateral transitional zone volume / transitional zone volume(|(TZV-L)-(TZV-R)|/TZV).Several date can be obtained by urodynamic examination as follows,: maximal urinary flow rate(Qmax),the detrusor pressure while the maximum urinary flow rate(Pdet Qmax).The coefficient of bladder outlet obstruction(AG)can be gained easily according to the formula AG= Pdet Qmax-2Qmax.And 30 cases of BPH were classified as seven levels of obstruction from 0-VI grades according to the pressure flow chart Schafer classification.Results: First of all,the contrastive analysis of AG of BPH patients and Schafer classification of pressure flow chart has confirmed that the AG value of bladder outlet obstruction coefficient of our experimental group can reflect the condition of bladder outlet obstruction accurately.The correlation analysis among the volume of the each part of prostate,age,PSA data and the urinary dynamics index of correlation is as follows.1.The correlation among AG and IPPV(r=0.3890,P=0.0336),IPPV/TPV(r=0.4983,P=0.0051),IPPV/TZV(r=0.4463,P=0.0134)has statistical difference,while is no statistical difference with TZV(r=0.07120,P=0.7085),TPV,PZV.2.The correlation among Qmax and IPPV(r=0.4275 P=0.0185),IPPV/TPV(r=0.3924,P = 0.032),| TZV-L-(TZV-R)| /TZV(r=-0.3654 P=0.0471)has statistical difference.And the last one has a negative correlation.It has no statistical difference with TPV,TZV,IPPV/TZV(r = 0.3479,P=0.0596).3.The correlation among Pdet Qmax and IPPV(r=0.4026,P=0.0274),IPPV/TPV(r=0.5548,P=0.0015),IPPV/TZV(r=0.4772,P=0.0077)has statistical difference,and it has no statistical difference with TPV,TZV.4.The correlation among Patients' age value Y and IPPV/TPV(r=-0.3847 P=0.0358),IPPV/TZV(r=-0.4906,P = 0.0059)has statistical difference,and it has no statistical difference with PSA(r=0.3493,P=0.0585),TPV(r=0.1226 P=0.5187),IPPV(r=-0.1170,P=0.3494).5.The correlation among PSA value and TPV(r=0.6036,P=0.0004),IPPV(r=0.3827,P=0.0369),TZV(r=0.5689,P=0.001)has statistical difference,and it has no statistical difference with AG,Pdet@Qmax,Qmax.Conclusion: The volume of intravesical prostatic protrusion part is one of the important reasons of bladder outlet obstruction caused by BPH patients.In our study,we haven't discovered the correlation between total prostate volume(or transitional zone volume)or urodynamic index.Asymmetry hyperplasia of both sides of the transitional zone,which is an important factor in affecting the maximum urinary flow rate,can make the curved urethra more bended and folded,and increase the resistance of the urethra.For BPH patients who need clinical surgical treatments,with prostatic hyperplasia of protruding into the bladder,we presume that if patients are with more basic diseases,older age and insupportableness of longer time of surgical treatment,we can singly resect the intravesical prostatic protrusion and make the bladder neck of rest prostate as “funnel-shaped”,and restore normal micturition anatomical structure of bladder outlet as far as possible.Besides,we need to repair the prostatic urethra area as far as possible to ensure equal of transitional zone on both sides of the urethra to make the urethra linearly and reduce tortuous degree of the urethra and maintain the normal anatomical position of urethra,which can decrease the urethral resistance and increase the maximum urinary flow rate so as to bring more appropriate treatment options for patients.