Smaller Prostate Volume, Lower Bladder Outlet Obstruction and Detrusor Contractility in Male Patients with Neurogenic Lower Urinary Tract Symptoms Compared to Benign Prostatic Hyperplasia

Objectives: Increasing prevalence of benign prostate hyperplasia (BPH) with age generates a need for differentiation of benign prostatic obstruction (BPO) due to BPH from neurogenic lower urinary dysfunction (NLUTD) in male patients with neurological diseases. Material and Methods: The clinical data of patients with spinal cord injury (SCI) or BPH alone underwent sonography videourodynamic studies (SVUDS) from Oct 2020 to Oct 2024 in the Second Affiliated Hospital of Guilin Medical University was retrospectively reviewed. Age, prostate volume (PV), peak flow rate (Qmax), post-voiding residual (PVR), bladder obstruction index (BOOI), and bladder contractility index (BCI) were compared between SCI patients with neurogenic lower urinary tract symptoms (NLUTS) and BPH patients with non-NLUTS (NNLUTS). Results: 8 male patients with SCI and NLUTS and 10 patients with NNLUTS due to BPH were recruited into this study. Lower age (49.3±9.9 years vs. 65.3±7.8 years), smaller PV (18.6±6.4 vs. 83.4±41.3ml), larger PVR (402.5±198.7 vs. 108.5±78.5ml), lower BOOI (21.0±10.9 vs. 98.3±40.8) and BCI (69.4±32.1 vs. 150.0±46.1) in patients with SCI and NLUTS were detected compared to BPH with NNLUTS (all P＜0.05). However, there was not a difference of Qmax between two groups between two groups (7.0±5.9 vs. 6.0±2.8ml/s, P=0.632). Conclusions: It was suggested that a milder BOOI and BCI, which leaded to a larger PVR, attributed to a smaller PV due to a lower traumatic age and denervation and the characterization of UDS images in SCI patients may facilitate the differentiation of NLUTS from NNLUTS.