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dc.contributor.advisorRuíz Steimberg, Jaime Enrique 
dc.creatorGaona Morales, José Luis 
dc.creatorSánchez León, Hugo Alexander 
dc.date.accessioned2018-06-06T14:36:30Z
dc.date.available2018-06-06T14:36:30Z
dc.date.created2018-05-18
dc.date.issued2018
dc.identifier.urihttp://repository.urosario.edu.co/handle/10336/18040
dc.descriptionIntroducción: La presencia de trabéculas severas en pacientes con hiperplasia prostática (HPB) y sintomatología urinaria supone un deterioro anatómico y funcional de la pared de la vejiga. Dicho deterioro conlleva a una mayor probabilidad de fracaso en el manejo farmacológico, pero existen pocas investigaciones al respecto. En este estudio, determinamos la asociación entre la presencia de trabéculas severas y el riesgo de prostatectomía en pacientes con HPB. Métodos: En este estudio retrospectivo de supervivencia analizamos las historias clínicas de 234 pacientes con HPB atendidos en Uromédica Ltda. en Bucaramanga, Colombia, quienes fueron manejados médicamente después de una cistoscopia. Las cistoscopias fueron realizadas entre 2007 y 2012, y se registró en cada paciente el tiempo de seguimiento y el hecho de que se haya realizado o no prostatectomía correctiva para su HPB. Se consideraron censurados aquellos pacientes que no fueron intervenidos. Se registraron valores de las siguientes variables independientes: grado de trabéculas, edad, volumen prostático, presencia de lóbulo medio, presencia de hiperplasia del cuello vesical, residuo postmiccional, capacidad vesical. Considerando la cirugía/tiempo de seguimiento como variable dependiente, se hizo un análisis bivariado con cada una de las variables independientes y una regresión de Cox con las variables que fueron significativas en el análisis bivariado. Se evaluaron también diferentes modelos de regresion incluyendo diferentes términos de interacción entre las diferentes variables independientes. Adicionalmente, se analizaron diferentes modelos de regresión para evaluar la existencia de factores confusores de la asociación entre trabéculas vesicales y la variable dependiente. Resultados: La mediana del tiempo de seguimiento fue de 25,1 meses. 81 pacientes (34,6%) fueron intervenidos quirúrgicamente. El análisis bivariado mostró que las variables independientes asociadas con un mayor riesgo de cirugía fueron las trabéculas severas, la edad, el PSA, el lóbulo medio, el residuo postmiccional y el volumen prostático. La supervicencia mediana libre de cirugía fue de 77,4 mees para los pacientes con trabéculas leves y 36,1 meses para los pacientes con trabéculas severas (p<0,001). El análisis multivariado mostró que las únicas variables asociadas al riesgo de cirugía fueron la presencia de trabéculas (p<0,001, HR = 3,83) y el PSA (p=0,002, HR = 1,09). No se encontraron interacciones entre las variables independientes. La única variable independiente que actuó como confusora de la asociación entre las trabéculas y el riesgo de cirugía fue el nivel de PSA. Conclusiones: Existe una asociación entre la presencia de trabéculas vesicales severas y el riesgo de prostatectomía en pacientes con sintomatología urinaria secundaria a HPB.
dc.description.abstractIntroduction: The presence of severe trabeculae in patients with prostatic hyperplasia (BPH) and urinary symptomatology supposes an anatomical and functional deterioration of the bladder wall. This deterioration leads to a greater probability of failure in pharmacological management, but there are few investigations in this regard. In this study, we determined the association between the presence of severe trabeculae and the risk of prostatectomy in patients with BPH. Methods: In this retrospective survival study, we analyzed the medical records of 234 patients with BPH attended at Uromédica in Bucaramanga, Colombia, who were medically managed after a cystoscopy. The cystoscopies were performed between 2007 and 2012, and the time of follow-up and the fact of having been operated was recorded in each patient. Those patients who were not operated were considered censored. Values of the following independent variables were recorded: degree of bladder trabeculation, age, prostate volume, presence of middle lobe, presence of bladder neck hyperplasia, postvoid residual, bladder capacity. Considering the surgery / follow-up time as a dependent variable, a bivariate analysis was made with each of the independent variables. A Cox regression was made with the variables that were significant in the bivariate analysis.We made different regression models including interaction between the different independent variables. Additionally, different regression models analyzed the existence of confounding factors of the association between bladder trabeculation and the dependent variable. Results: The median follow-up time was 25.1 months. 81 patients (34.6%) underwent surgery. The bivariate analysis showed that the independent variables associated with an increased risk of surgery are severe trabeculae, age, PSA, middle lobe, postvoid residual and prostatic volume. The median surgery free survival was 77.4 months for patients with mild trabeculae and 36.1 months for patients with severe trabeculae (p <0.001). The multivariate analysis showed that the variables associated with surgery risk were the presence of bladder trabeculation (p <0.001, HR = 3.83) and PSA (p = 0.002, HR = 1.09). No interactions were found between the independent variables. The only independent variable that acted as a confounder of the association between the trabeculae and the risk of surgery was the PSA level. Conclusion: There is an association between the presence of severe bladder trabeculation and the risk of prostatectomy in patients with urinary symptoms secondary to BPH.
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dc.language.isospa
dc.sourceinstname:Universidad del Rosario
dc.sourcereponame:Repositorio Institucional EdocUR
dc.subjectTrabéculas vesicales
dc.subjectProstatectomía
dc.subjectHiperplasia prostática
dc.subjectSintomatología urinaria baja
dc.subject.ddcEnfermedades 
dc.subject.lembEnfermedades de la próstata
dc.subject.lembProstatectomía
dc.titleAsociación entre las trabéculas vesicales severas y la realización de prostatectomía en pacientes con síntomatología urinaria asociada a hiperplasia prostática, atendidos en Uromédica entre los años 2007 y 2017
dc.typemasterThesis
dc.publisherUniversidad del Rosario
dc.creator.degreeMagíster en epidemiología
dc.publisher.programMaestría en Epidemiología
dc.publisher.departmentFacultad de medicina
dc.subject.keywordProstatic hyperplasia
dc.subject.keywordUrinary low symptomatology
dc.subject.keywordBladder trabeculation
dc.rights.accesRightsinfo:eu-repo/semantics/openAccess
dc.type.spaTesis de maestría
dc.rights.accesoAbierto (Texto Completo)
dc.type.hasVersioninfo:eu-repo/semantics/acceptedVersion
dc.source.bibliographicCitation1. Nair SM, Pimentel MA, Gilling PJ. Evolving and investigational therapies for benign prostatic hyperplasia. The Canadian journal of urology. 2015;22 Suppl 1:82-7.
dc.source.bibliographicCitation2. Logie JW, Clifford GM, Farmer RD, Meesen BP. Lower urinary tract symptoms suggestive of benign prostatic obstruction--Triumph: the role of general practice databases. European urology. 2001;39 Suppl 3:42-7.
dc.source.bibliographicCitation3. Lepor H. Pathophysiology, epidemiology, and natural history of benign prostatic hyperplasia. Reviews in urology. 2004;6 Suppl 9:S3-s10
dc.source.bibliographicCitation4. Levin RM, Monson FC, Haugaard N, Buttyan R, Hudson A, Roelofs M, et al. Genetic and cellular characteristics of bladder outlet obstruction. The Urologic clinics of North America. 1995;22(2):263-83.
dc.source.bibliographicCitation5. Barry MJ, Cockett AT, Holtgrewe HL, McConnell JD, Sihelnik SA, Winfield HN. Relationship of symptoms of prostatism to commonly used physiological and anatomical measures of the severity of benign prostatic hyperplasia. The Journal of urology. 1993;150(2 Pt 1):351-8.
dc.source.bibliographicCitation6. Cho SY, Bae J, Yoo C, Oh SJ. Establishment of a grading system for bladder trabeculation. Urology. 2013;81(3):503-7.
dc.source.bibliographicCitation7. Madsen FA, Bruskewitz RC. Cystoscopy in the evaluation of benign prostatic hyperplasia. World journal of urology. 1995;13(1):14-6.
dc.source.bibliographicCitation8. Salah Azab S, Elsheikh MG. The impact of the bladder wall thickness on the outcome of the medical treatment using alpha-blocker of BPH patients with LUTS. Aging Male. 2015 Jun;18(2):89-92.
dc.source.bibliographicCitation9. Gratzke C, Bachmann A, Descazeaud A, Drake MJ, Madersbacher S, Mamoulakis C,Oelke M, Tikkinen KAO, Gravas S. EAU Guidelines on the Assessment of Non-neurogenic Male Lower Urinary Tract Symptoms including Benign Prostatic Obstruction. Eur Urol. 2015 Jun;67(6):1099-1109.
dc.source.bibliographicCitation10. McVary KT, Roehrborn CG, Avins AL, Barry MJ, Bruskewitz RC, Donnell RF, et al. Update on AUA guideline on the management of benign prostatic hyperplasia. The Journal of urology. 2011;185(5):1793-803.
dc.source.bibliographicCitation11. Naranjo-Ortiz C, Shek KL, Martin AJ, Dietz HP. What is normal bladder neckanatomy? Int Urogynecol J. 2016 Jun;27(6):945-50
dc.source.bibliographicCitation12. T. W. Sadler JL. Embriología médica con orientación clínica. 12 edSeptiembre 2012
dc.source.bibliographicCitation13. Chatain Ives BJ. Anatomia Macroscopica, Funcional y Clinica Sistemas Tecnicos de Edicion S.A ed: addison wesley iberoamericana S.A 1986
dc.source.bibliographicCitation14. Shapiro E, Hartanto V, Lepor H. Quantifying the smooth muscle content of the prostate using double-immunoenzymatic staining and color assisted image analysis. The Journal of urology. 1992;147(4):1167-70.
dc.source.bibliographicCitation15. Aaron L, Franco OE, Hayward SW. Review of Prostate Anatomy and Embryology and the Etiology of Benign Prostatic Hyperplasia. The Urologic clinics of North America. 2016;43(3):279-88.
dc.source.bibliographicCitation16. Campbell MF, Walsh PC, Retik AB. Campbell's Urology: Filadelfia (Pensilvania, Estados Unidos) Saunders 2002 8th ed; 2002.
dc.source.bibliographicCitation17. Hall JE, Guyton AC. Tratado de fisiología médica: Barcelona (España) Elservier McGraw-Hill 2011 12a ed; 2011.
dc.source.bibliographicCitation18. Netter FH, Götzens García V. Atlas de anatomía humana: Ámsterdam (Holanda) Elsevier 2015 6a ed; 2015.
dc.source.bibliographicCitation19. Berry SJ, Coffey DS, Walsh PC, Ewing LL. The development of human benign prostatic hyperplasia with age. The Journal of urology. 1984;132(3):474-9.
dc.source.bibliographicCitation20. Rhodes T, Girman CJ, Jacobsen SJ, Roberts RO, Guess HA, Lieber MM. Longitudinal prostate growth rates during 5 years in randomly selected community men 40 to 79 years old. The Journal of urology. 1999;161(4):1174-9.
dc.source.bibliographicCitation21. Chute CG, Panser LA, Girman CJ, Oesterling JE, Guess HA, Jacobsen SJ, et al. The prevalence of prostatism: a population-based survey of urinary symptoms. The Journal of urology. 1993;150(1):85-9.
dc.source.bibliographicCitation22. Tsukamoto T, Kumamoto Y, Masumori N, Miyake H, Rhodes T, Girman CJ, et al. Prevalence of prostatism in Japanese men in a community-based study with comparison to a similar American study. The Journal of urology. 1995;154(2 Pt 1):391-5.
dc.source.bibliographicCitation23. Bosch JL, Hop WC, Kirkels WJ, Schroder FH. The International Prostate Symptom Score in a community-based sample of men between 55 and 74 years of age: prevalence and correlation of symptoms with age, prostate volume, flow rate and residual urine volume. British journal of urology. 1995;75(5):622-30.
dc.source.bibliographicCitation24. Garraway WM, Collins GN, Lee RJ. High prevalence of benign prostatic hypertrophy in the community. Lancet (London, England). 1991;338(8765):469-71.
dc.source.bibliographicCitation25. Kristal AR, Arnold KB, Schenk JM, Neuhouser ML, Weiss N, Goodman P, et al. Race/ethnicity, obesity, health related behaviors and the risk of symptomatic benign prostatic hyperplasia: results from the prostate cancer prevention trial. The Journal of urology. 2007;177(4):1395-400; quiz 591.
dc.source.bibliographicCitation26. Verhamme KM, Dieleman JP, Bleumink GS, van der Lei J, Sturkenboom MC, Artibani W, et al. Incidence and prevalence of lower urinary tract symptoms suggestive of benign prostatic hyperplasia in primary care--the Triumph project. European urology. 2002;42(4):323-8.
dc.source.bibliographicCitation27. Platz EA, Joshu CE, Mondul AM, Peskoe SB, Willett WC, Giovannucci E. Incidence and progression of lower urinary tract symptoms in a large prospective cohort of United States men. The Journal of urology. 2012;188(2):496-501.
dc.source.bibliographicCitation28. Bierhoff E, Vogel J, Benz M, Giefer T, Wernert N, Pfeifer U. Stromal nodules in benign prostatic hyperplasia. European urology. 1996;29(3):345-54.
dc.source.bibliographicCitation29. McNeal J. Pathology of benign prostatic hyperplasia. Insight into etiology. The Urologic clinics of North America. 1990;17(3):477-86.
dc.source.bibliographicCitation30. Bushman W. Etiology, epidemiology, and natural history of benign prostatic hyperplasia. The Urologic clinics of North America. 2009;36(4):403-15, v
dc.source.bibliographicCitation31. Coffey DS, Walsh PC. Clinical and experimental studies of benign prostatic hyperplasia. The Urologic clinics of North America. 1990;17(3):461-75
dc.source.bibliographicCitation32. Belanger A, Candas B, Dupont A, Cusan L, Diamond P, Gomez JL, et al. Changes in serum concentrations of conjugated and unconjugated steroids in 40- to 80-year-old men. The Journal of clinical endocrinology and metabolism. 1994;79(4):1086-90.
dc.source.bibliographicCitation33. Kaufman JM. The effect of androgen supplementation therapy on the prostate. The aging male : the official journal of the International Society for the Study of the Aging Male. 2003;6(3):166-74.
dc.source.bibliographicCitation34. De Marzo AM, Nakai Y, Nelson WG. Inflammation, atrophy, and prostate carcinogenesis. Urologic oncology. 2007;25(5):398-400.
dc.source.bibliographicCitation35. Parsons JK, Carter HB, Partin AW, Windham BG, Metter EJ, Ferrucci L, et al. Metabolic factors associated with benign prostatic hyperplasia. The Journal of clinical endocrinology and metabolism. 2006;91(7):2562-8.
dc.source.bibliographicCitation36. Keren A, Popp RL. Assignment of patients into the classification of cardiomyopathies. Circulation. 1992;86(5):1622-33.
dc.source.bibliographicCitation37. Girman CJ, Jacobsen SJ, Guess HA, Oesterling JE, Chute CG, Panser LA, et al. Natural history of prostatism: relationship among symptoms, prostate volume and peak urinary flow rate. The Journal of urology. 1995;153(5):1510-5.
dc.source.bibliographicCitation38. Lepor H. Medical therapy for benign prostatic hyperplasia. Urology. 1993;42(5):483501.
dc.source.bibliographicCitation39. Nordling J. The aging bladder--a significant but underestimated role in the development of lower urinary tract symptoms. Experimental gerontology. 2002;37(8-9):991-9
dc.source.bibliographicCitation40. Jacobsen SJ, Girman CJ, Guess HA, Rhodes T, Oesterling JE, Lieber MM. Natural history of prostatism: longitudinal changes in voiding symptoms in community dwelling men. The Journal of urology. 1996;155(2):595-600.
dc.source.bibliographicCitation41. McConnell JD, Roehrborn CG, Bautista OM, Andriole GL, Jr., Dixon CM, Kusek JW, et al. The long-term effect of doxazosin, finasteride, and combination therapy on the clinical progression of benign prostatic hyperplasia. The New England journal of medicine. 2003;349(25):2387-98
dc.source.bibliographicCitation42. Hecht SL, Hedges JC. Diagnostic Work-Up of Lower Urinary Tract Symptoms. The Urologic clinics of North America. 2016;43(3):299-309.
dc.source.bibliographicCitation43. Barry MJ, Fowler FJ, Jr., O'Leary MP, Bruskewitz RC, Holtgrewe HL, Mebust WK, et al. The American Urological Association symptom index for benign prostatic hyperplasia. The Measurement Committee of the American Urological Association. The Journal of urology. 1992;148(5):1549-57; discussion 64.
dc.source.bibliographicCitation44. Cornu JN. Bipolar, Monopolar, Photovaporization of the Prostate, or Holmium Laser Enucleation of the Prostate: How to Choose What's Best? The Urologic clinics of North America. 2016;43(3):377-84.
dc.source.bibliographicCitation45. el Din KE, de Wildt MJ, Rosier PF, Wijkstra H, Debruyne FM, de la Rosette JJ. The correlation between urodynamic and cystoscopic findings in elderly men with voiding complaints. The Journal of urology. 1996;155(3):1018-22.
dc.source.bibliographicCitation46. Topazio L, Perugia C, De Nunzio C, Gaziev G, Iacovelli V, Bianchi D,Vespasiani G, Finazzi Agrò E. Intravescical prostatic protrusion is a predictor of alpha blockers response: results from an observational study. BMC Urol. 2018;18(1):6.
dc.source.bibliographicCitation47. Mehraban D. Clinical value of intravesical prostatic protrusion in the evaluation and management of prostatic and other lower urinary tract diseases.Asian J Urol. 2017 Jul;4(3):174-180.
dc.source.bibliographicCitation48. Ko YH, Kim TH, Song PH, Kim BH, Kim BS, Kim KH, Cho J; KYUS Group. Structural Variations of the Prostatic Urethra Within the Prostate Predict the Severities of Obstructive Symptoms: A Prospective Multicenter Observational Study. Urology.2017 Jun;104:160-165
dc.source.bibliographicCitation49. Kim BH, Kim KH, Ko YH, Song PH, Kim TH, Kim BS. The prostatic urethral angle can predict the response to alpha adrenoceptor antagonist monotherapy for treating nocturia in men with lower urinary tract symptom: A multicenter study.Prostate Int. 2016 Mar;4(1):30
dc.source.bibliographicCitation50. Averbeck MA, De Lima NG, Motta GA, Beltrao LF, Abboud Filho NJ, Rigotti CP,Dos Santos WN, Dos Santos SKJ, Da Silva LFB, Rhoden EL. Collagen content in the bladder of men with LUTS undergoing open prostatectomy: A pilot study. Neurourol Urodyn. 2018 Mar;37(3):1088-109
dc.source.bibliographicCitation51. Malde S, Nambiar AK, Umbach R, Lam TB, Bach T, Bachmann A, Drake MJ, Gacci M, Gratzke C, Madersbacher S, Mamoulakis C, Tikkinen KA, Gravas S; European Association of Urology Non-neurogenic Male LUTS Guidelines Panel. Systematic Review of the Performance of Noninvasive Tests in Diagnosing Bladder Outlet Obstruction in Men with Lower Urinary Tract Symptoms. Eur Urol. 2017 Mar;71(3):391-402.
dc.source.bibliographicCitation52. Park JS, Lee HW, Lee SW, Moon HS, Park HY, Kim YT. Bladder Wall Thickness is Associated with Responsiveness of Storage Symptoms to Alpha-Blockers in Men with Lower Urinary Tract Symptoms. Korean J Urol. 2012 Jul;53(7):487-91
dc.source.bibliographicCitation53. Lee HN, Lee YS, Han DH, Lee KS. Change of Ultrasound Estimated Bladder Weight and Bladder Wall Thickness After Treatment of Bladder Outlet Obstruction With Dutasteride. Low Urin Tract Symptoms. 2017 May;9(2):67-74.
dc.source.bibliographicCitation54. Tubaro A, Mariani S, De Nunzio C, Miano R. Bladder weight and detrusor thickness as parameters of progression of benign prostatic hyperplasia. Curr Opin Urol. 2010 Jan;20(1):37-42.
dc.source.bibliographicCitation55. Karakose A, Aydogdu O, Atesci YZ. The relationship between bladder wall thickness and lower urinary tract symptoms: Does bladder wall thickness change after alpha-blocker therapy with alfuzosin? Can Urol Assoc J. 2014 Jan-Feb;8(1-2):E26-9.
dc.source.bibliographicCitation56. Bellucci CHS, Ribeiro WO, Hemerly TS, de Bessa J Jr, Antunes AA, Leite KRM,Bruschini H, Srougi M, Gomes CM. Increased detrusor collagen is associated with detrusor overactivity and decreased bladder compliance in men with benign prostatic obstruction. Prostate Int. 2017 Jun;5(2):70-74.
dc.source.bibliographicCitation57. Qizilbash N, Emberton M, Fitzpatrick JM, Garcia-Losa M, Djavan B. Progression of benign prostatic hyperplasia: Systematic review of the placebo arms of clinical trials. BJU International. 2008;102(8):981-6.
dc.source.bibliographicCitation58. Presicce F, De Nunzio C, Tubaro A. Can Long-term LUTS/BPH Pharmacological Treatment Alter the Outcomes of Surgical Intervention? Current Urology Reports. 2017;18(9)
dc.source.bibliographicCitation59. El-Zawahry A, Alanee S, Malan-Elzawahry A. The Use of Urodynamics Assessment Before the Surgical Treatment of BPH. Current Urology Reports. 2016;17(10).
dc.source.bibliographicCitation60. Sandhu J. Management of elevated prostate-specific antigen in men with nonbacterial chronic prostatitis. Current Urology Reports. 2009;10(4):302.
dc.source.bibliographicCitation61. Nickel JC, Roehrborn CG, O'Leary MP, Bostwick DG, Somerville MC, Rittmaster RS. Benign Prostatic Hyperplasia: The Relationship between Prostate Inflammation and Lower Urinary Tract Symptoms: Examination of Baseline Data from the REDUCE Trial. European Urology. 2008;54:1379-84
dc.source.bibliographicCitation62. Gandaglia G, Briganti A, Salonia A, Montorsi F, Gontero P, Mondaini N, et al. The role of chronic prostatic inflammation in the pathogenesis and progression of benign prostatic hyperplasia (BPH). BJU International. 2013;112(4):432-41.
dc.source.bibliographicCitation63. De Groat WC, Yoshimura N. Anatomy and physiology of the lower urinary tract. Handb Clin Neurol. 2015;130:61-108.
dc.source.bibliographicCitation64. Lecci A, Maggi CA. Invited review: Tachykinins as modulators of the micturition reflex in the central and peripheral nervous system. Regulatory Peptides. 2001;101:1-18
dc.source.bibliographicCitation65. Mehraban D. Clinical value of intravesical prostatic protrusion in the evaluation and management of prostatic and other lower urinary tract diseases. Asian Journal of Urology. 2017;4(3):174-80
dc.source.bibliographicCitation66. Loeb S, Catalona WJ. Prostate-specific antigen in clinical practice. Cancer Letters. 2007;249(1):30-9.
dc.source.bibliographicCitation67. Foo KT. Review: Pathophysiology of clinical benign prostatic hyperplasia. Asian Journal of Urology. 2017;4:152-7
dc.source.bibliographicCitation68. Kijvikai K. Digital rectal examination, serum prostatic specific antigen or transrectal ultrasonography: The best tool to guide the treatment of men with benign prostatic hyperplasia. Current Opinion in Urology. 2009;19(1):44-8.
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