Category: BPH/LUTS: Electrosurgery, Lasers & Other Technology

MP6-13 - Lung function (forced vital capacity) and second to fourth digit ratio are associated with maximum urinary flow rate after holmium laser enucleation of the prostate

Fri, Sep 21
10:00 AM - 12:00 PM

Introduction & Objective :

Benign prostatic hyperplasia (BPH) is associated with sex hormone. Second to fourth digit ratio (digit ratio) is also related to sex hormone and BPH. Lung function (chronic obstructive pulmonary disease (COPD)) is also related to sex hormone and lower urinary tract symptoms (LUTS). These suggest that digit ratio and lung function might be related to the outcome of BPH treatment. However, to date, there are no studies that have studied digit ratio and lung function as potential predictors for BPH treatment outcome. To date, holmium laser enucleation of the prostate (HoLEP) is considered a safe and effective treatment modality for BPH. Although maximum urinary flow rate (Qmax) is mostly improved after HoLEP, Qmax after HoLEP varies from patient to patient. Moreover, the results on the potential predictors of Qmax after HoLEP have not been consistent. Thus, we investigated preoperative variables including digit ratio and pulmonary function test (PFT) findings as potential predictors of Qmax after HoLEP.


Methods :

One hundred and ninety-five (n = 195) consecutive patients that underwent HoLEP were enrolled. Before the HoLEP, the PFTs were performed and the lengths of the second and fourth digits of the right hand were measured by a single investigator using a digital vernier calliper. To identify the independent predictive factors influencing Qmax after HoLEP, univariate and multivariate analyses were performed using linear regression models.


Results :

Mean age and digit ratio of all subjects were 69.4 years and 0.939, respectively. Mean forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1) were 3.57 L and 2.59 L, respectively. Mean prostate specific antigen (PSA), total prostate volume (TPV), and transitional zone volume (TZV) were 4.04 ng/mL, 63.3 mL, and 34.0 mL, respectively. Mean preoperative and postoperative Qmax were 8.7 mL/s and 26.2 mL/s, respectively. In the univariate analysis, age (r = -0.181, p = 0.014), digit ratio (r = 0.213, p = 0.004), lung function (FVC: r = 0.218, p = 0.005; FEV1: r = 0.166, p = 0.034), preoperative Qmax (r = 0.264, p = 0.000), preoperative voided volume (VV) (r = 0.158, p = 0.033), and postoperative VV (r = 0.311, p = 0.000) were associated with postoperative Qmax. The multivariate analysis showed that digit ratio (β = 0.285, p = 0.001), FVC (β = 0.340, p = 0.039), and postoperative VV (β = 0.301, p = 0.000) were the independent predictive factors influencing Qmax after HoLEP.


Conclusions :

The independent predictive factors influencing Qmax after HoLEP were digit ratio and lung function (FVC) as well as postoperative VV. This means that the higher a man’s digit ratio and lung function (FVC), the higher his Qmax after HoLEP.

Tae Beom Kim

Associate Professor
Department of Urology, Gachon University Gil Hospital
Incheon, Inch'on-jikhalsi, Republic of Korea

I-Nae Park

Associate Professor
Department of Pulmonology, Inje University Seoul Paik Hospital
Seoul, Seoul-t'ukpyolsi, Republic of Korea

Chang Hee Kim

Assistant Professor
Department of Urology, Gachon University Gil Hospital
Incheon, Inch'on-jikhalsi, Republic of Korea

Kwang Taek Kim

Assistant Professor
Department of Urology, Gachon University Gil Hospital
Incheon, Inch'on-jikhalsi, Republic of Korea

Jin Kyu Oh

Assistant Professor
Department of Urology, Gachon University Gil Hospital
Incheon, Inch'on-jikhalsi, Republic of Korea

Kyung Jin Chung

Associate Professor
Department of Urology, Gachon University Gil Hospital
Incheon, Inch'on-jikhalsi, Republic of Korea

Khae-Hawn Kim

Associate Professor
Department of Urology, Gachon University Gil Hospital
Inchoen, Inch'on-jikhalsi, Republic of Korea

Han Jung

Associate Professor
Department of Urology, Gachon University Gil Hospital
Incheon, Inch'on-jikhalsi, Republic of Korea

Sang Jin Yoon

Professor
Department of Urology, Gachon University Gil Hospital
Incheon, Inch'on-jikhalsi, Republic of Korea