DAYTIME CHANGES IN UROFLOW PARAMETERS IN BPH WITH LOWER URINARY TRACT SYMTOMPS

Introduction: The aim of this study was to evaluate changes that occurred in uroflow parameters during daytime in patients with BPH and varicocele patients who were chosen as a control group. Materials and Methods: Patients who were hospitalized with the diagnosis of BPH and varicocele between February 2003 and June 2005 participated in this study. Those patients suffering from urethra stenosis, urinary infection, prostate cancer, bladder neck sclerosis, bladder stones and tumors, or those who had an operation due to aforementioned disorders, and the patients who had to have a bladder catheter within the last one month, and finally the patients who received medical treatment due to BPH were excluded from the study. The uroflow results where the miction amount was less than 100 cc were disregarded. The patients were divided into two: Group 1 with 47 patients and Group 2 with 46 patients, amounting to 93 patients. The average age for each group was 62.83 +/- 7.04 (45-73) and 26.17 +/- 5.53 (15-59) respectively. The device used in the case study was Laborie Uroscan uroflowmeter. Uroflow was administered to each patient four times; between 7.00 and 8.00 a.m. (assessment 1); between 11.00 and 12.00 a.m. (assessment 2); between 4.00 and 5.00 p.m. (assessment 3); and between 8.00 and 9.00 p.m. (assessment 4). In each test, maximum flow, average flow, and urine volume were recorded. The results were compared by means of the Wilcoxon signed rank test. Results: In the first group, fourth assessments were found to be significantly higher than the first, second and third assessments in terms of maximum flow. Considering the average flow, the fourth assessments were also identified to be significantly higher than the second and third assessments (p<0.05). There was no significant difference between the assessments 1 v 2, 1 v 3, 2 v 3 (p>0.05). In the second group, the fourth assessments were found to be significantly higher than the first and the third assessments with respect to the maximum flow (p<0.05). Conclusion: In the present study, the values recorded between 8.00 and 9.00 p.m. were found to be higher in terms of maximum flow, average flow and urine volume in both groups. If only the uroflow values taken between 8.00 and 9.00 p.m. had been taken into consideration in evaluating the lower urinary system obstruction, 10 % of the patients would have been considered normal. These results suggest that it will be misleading if the uroflows are administered during the evening. In order to reach a definite judgement on this issue, there is a need to carry out the experiment with a greater number of patients and in a multi-centric manner.