Relationship Between Prostatic Urethral Angle and Urinary Flow Rate: Its Implication in Benign Prostatic Hyperplasia Pathogenesis

Kang Su Cho, Joo Han Kim, Dong Jun Kim, Young Deuk Choi, Jang Hwan Kim, Sung Joon Hong

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

Objectives: The prostatic urethra is a bent tube, and the clinical significance of the prostatic urethral angle (PUA) is poorly understood. We investigated the effect of the PUA on the urinary flow rate in men without benign prostatic obstruction. Methods: In a theoretical model, the urinary flow rate at the end of the prostatic urethra was formulated according to some principles of fluid dynamics, including the Navier-Storkes equation, Bernoulli's equation, and the loss of coefficient at bends. The change in the urinary flow rate according to the PUA was also calculated through mathematical simulations. In addition, the relationship between the PUA and the peak flow rate was evaluated in 65 healthy men without benign prostatic obstruction (age 50 to 59 years, prostate volume less than 30 cm3, peak flow rate greater than 15 mL/s). The prostate volume and PUA were determined by transrectal ultrasonography. Results: Using the fluid dynamic model, the urinary flow rate increased in proportion to the urethral diameter and was inversely associated with the PUA. The mathematical simulations showed that the urinary flow rate decreased by more than 27% as the PUA increased from 35° to 90°. In the clinical setting, the peak flow rate was significantly associated with the PUA by linear regression analysis (R = 0.34, β = -0.342, P = 0.005), but it was not associated with the total prostate volume (R = 0.18, β = -0.181, P = 0.150). Conclusions: The PUA was inversely associated with the urinary flow rate in this theoretical model and preliminary clinical study. This relationship could be an important factor in the pathogenesis of benign prostatic hyperplasia/lower urinary tract symptoms.

Original languageEnglish
Pages (from-to)858-862
Number of pages5
JournalUrology
Volume71
Issue number5
DOIs
Publication statusPublished - 2008 May 1

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Prostatic Hyperplasia
Prostate
Urethra
Hydrodynamics
Theoretical Models
Lower Urinary Tract Symptoms
Linear Models
Ultrasonography
Regression Analysis

All Science Journal Classification (ASJC) codes

  • Urology

Cite this

Cho, Kang Su ; Kim, Joo Han ; Kim, Dong Jun ; Choi, Young Deuk ; Kim, Jang Hwan ; Hong, Sung Joon. / Relationship Between Prostatic Urethral Angle and Urinary Flow Rate : Its Implication in Benign Prostatic Hyperplasia Pathogenesis. In: Urology. 2008 ; Vol. 71, No. 5. pp. 858-862.
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abstract = "Objectives: The prostatic urethra is a bent tube, and the clinical significance of the prostatic urethral angle (PUA) is poorly understood. We investigated the effect of the PUA on the urinary flow rate in men without benign prostatic obstruction. Methods: In a theoretical model, the urinary flow rate at the end of the prostatic urethra was formulated according to some principles of fluid dynamics, including the Navier-Storkes equation, Bernoulli's equation, and the loss of coefficient at bends. The change in the urinary flow rate according to the PUA was also calculated through mathematical simulations. In addition, the relationship between the PUA and the peak flow rate was evaluated in 65 healthy men without benign prostatic obstruction (age 50 to 59 years, prostate volume less than 30 cm3, peak flow rate greater than 15 mL/s). The prostate volume and PUA were determined by transrectal ultrasonography. Results: Using the fluid dynamic model, the urinary flow rate increased in proportion to the urethral diameter and was inversely associated with the PUA. The mathematical simulations showed that the urinary flow rate decreased by more than 27{\%} as the PUA increased from 35° to 90°. In the clinical setting, the peak flow rate was significantly associated with the PUA by linear regression analysis (R = 0.34, β = -0.342, P = 0.005), but it was not associated with the total prostate volume (R = 0.18, β = -0.181, P = 0.150). Conclusions: The PUA was inversely associated with the urinary flow rate in this theoretical model and preliminary clinical study. This relationship could be an important factor in the pathogenesis of benign prostatic hyperplasia/lower urinary tract symptoms.",
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Relationship Between Prostatic Urethral Angle and Urinary Flow Rate : Its Implication in Benign Prostatic Hyperplasia Pathogenesis. / Cho, Kang Su; Kim, Joo Han; Kim, Dong Jun; Choi, Young Deuk; Kim, Jang Hwan; Hong, Sung Joon.

In: Urology, Vol. 71, No. 5, 01.05.2008, p. 858-862.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Relationship Between Prostatic Urethral Angle and Urinary Flow Rate

T2 - Its Implication in Benign Prostatic Hyperplasia Pathogenesis

AU - Cho, Kang Su

AU - Kim, Joo Han

AU - Kim, Dong Jun

AU - Choi, Young Deuk

AU - Kim, Jang Hwan

AU - Hong, Sung Joon

PY - 2008/5/1

Y1 - 2008/5/1

N2 - Objectives: The prostatic urethra is a bent tube, and the clinical significance of the prostatic urethral angle (PUA) is poorly understood. We investigated the effect of the PUA on the urinary flow rate in men without benign prostatic obstruction. Methods: In a theoretical model, the urinary flow rate at the end of the prostatic urethra was formulated according to some principles of fluid dynamics, including the Navier-Storkes equation, Bernoulli's equation, and the loss of coefficient at bends. The change in the urinary flow rate according to the PUA was also calculated through mathematical simulations. In addition, the relationship between the PUA and the peak flow rate was evaluated in 65 healthy men without benign prostatic obstruction (age 50 to 59 years, prostate volume less than 30 cm3, peak flow rate greater than 15 mL/s). The prostate volume and PUA were determined by transrectal ultrasonography. Results: Using the fluid dynamic model, the urinary flow rate increased in proportion to the urethral diameter and was inversely associated with the PUA. The mathematical simulations showed that the urinary flow rate decreased by more than 27% as the PUA increased from 35° to 90°. In the clinical setting, the peak flow rate was significantly associated with the PUA by linear regression analysis (R = 0.34, β = -0.342, P = 0.005), but it was not associated with the total prostate volume (R = 0.18, β = -0.181, P = 0.150). Conclusions: The PUA was inversely associated with the urinary flow rate in this theoretical model and preliminary clinical study. This relationship could be an important factor in the pathogenesis of benign prostatic hyperplasia/lower urinary tract symptoms.

AB - Objectives: The prostatic urethra is a bent tube, and the clinical significance of the prostatic urethral angle (PUA) is poorly understood. We investigated the effect of the PUA on the urinary flow rate in men without benign prostatic obstruction. Methods: In a theoretical model, the urinary flow rate at the end of the prostatic urethra was formulated according to some principles of fluid dynamics, including the Navier-Storkes equation, Bernoulli's equation, and the loss of coefficient at bends. The change in the urinary flow rate according to the PUA was also calculated through mathematical simulations. In addition, the relationship between the PUA and the peak flow rate was evaluated in 65 healthy men without benign prostatic obstruction (age 50 to 59 years, prostate volume less than 30 cm3, peak flow rate greater than 15 mL/s). The prostate volume and PUA were determined by transrectal ultrasonography. Results: Using the fluid dynamic model, the urinary flow rate increased in proportion to the urethral diameter and was inversely associated with the PUA. The mathematical simulations showed that the urinary flow rate decreased by more than 27% as the PUA increased from 35° to 90°. In the clinical setting, the peak flow rate was significantly associated with the PUA by linear regression analysis (R = 0.34, β = -0.342, P = 0.005), but it was not associated with the total prostate volume (R = 0.18, β = -0.181, P = 0.150). Conclusions: The PUA was inversely associated with the urinary flow rate in this theoretical model and preliminary clinical study. This relationship could be an important factor in the pathogenesis of benign prostatic hyperplasia/lower urinary tract symptoms.

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