전립선비대증 변증도구의 신뢰도 평가 및 IPSS, 요속과의 상관관계에 대한 탐색적 연구

전천후,구지향,강위창,장은수,이은정,정인철,조충식 대한한방내과학회 2020 大韓韓方內科學會誌 Vol.41 No.6

Objectives: To evaluate the reliability of a pattern identification tool for benign prostatic hyperplasia and to examine the relationship between pattern identification tool readings and IPSS and uroflowmetry. Methods: We analyzed 56 patients diagnosed with benign prostatic hyperplasia from December 27th, 2017 to December 26th, 2018 by two different Korean medical doctors and followed with a pattern identification tool and by IPSS and uroflowmetry. One week later, the patients were retested to analyze the reliability of the pattern identification tool, determined with the intraclass correlation coefficient (ICC) using the test-retest method. The correlation between IPSS and uroflowmetry was analyzed with the Pearson coefficient. Result: The reliability of the pattern identification tool for benign prostatic hyperplasia was evaluated as “poor agreement beyond chance” (ICC=0.349). The reliability of each pattern identification score was evaluated as “good” for Yang Deficiency of Kidney, Yin Deficiency of Kidney, Deficiency of Middle Qi, and Dampness-heat of Lower Energizer. The internal consistency was evaluated as “good” for Yang Deficiency of Kidney, Yin Deficiency of Kidney, and Dampness-heat of Lower Energizer, and as “excellent” for Deficiency of Middle Qi. The correlation between pattern identification and IPSS was evaluated as a “moderate positive correlation” for all pattern identifications. The average flow rate and maximum flow rate using uroflowmetry was evaluated with “moderate negative correlation” for Yang Deficiency of Kidney and Dampness-heat of Lower Energizer. Conclusion: The reliability of a pattern identification tool for benign prostatic hyperplasia was evaluated as “poor agreement beyond chance.” Further research is needed. Objectives: To evaluate the reliability of a pattern identification tool for benign prostatic hyperplasia and to examine the relationship between pattern identification tool readings and IPSS and uroflowmetry. Methods: We analyzed 56 patients diagnosed with benign prostatic hyperplasia from December 27th, 2017 to December 26th, 2018 by two different Korean medical doctors and followed with a pattern identification tool and by IPSS and uroflowmetry. One week later, the patients were retested to analyze the reliability of the pattern identification tool, determined with the intraclass correlation coefficient (ICC) using the test-retest method. The correlation between IPSS and uroflowmetry was analyzed with the Pearson coefficient. Result: The reliability of the pattern identification tool for benign prostatic hyperplasia was evaluated as “poor agreement beyond chance” (ICC=0.349). The reliability of each pattern identification score was evaluated as “good” for Yang Deficiency of Kidney, Yin Deficiency of Kidney, Deficiency of Middle Qi, and Dampness-heat of Lower Energizer. The internal consistency was evaluated as “good” for Yang Deficiency of Kidney, Yin Deficiency of Kidney, and Dampness-heat of Lower Energizer, and as “excellent” for Deficiency of Middle Qi. The correlation between pattern identification and IPSS was evaluated as a “moderate positive correlation” for all pattern identifications. The average flow rate and maximum flow rate using uroflowmetry was evaluated with “moderate negative correlation” for Yang Deficiency of Kidney and Dampness-heat of Lower Energizer. Conclusion: The reliability of a pattern identification tool for benign prostatic hyperplasia was evaluated as “poor agreement beyond chance.” Further research is needed. Objectives: To evaluate the reliability of a pattern identification tool for benign prostatic hyperplasia and to examine the relationship between pattern identification tool readings and IPSS and uroflowmetry. Methods: We analyzed 56 patients diagnosed with benign prostatic hyperplasia from December 27th, 2017 to December 26th, 2018 by two different Korean medical doctors and followed with a pattern identification tool and by IPSS and uroflowmetry. One week later, the patients were retested to analyze the reliability of the pattern identification tool, determined with the intraclass correlation coefficient (ICC) using the test-retest method. The correlation between IPSS and uroflowmetry was analyzed with the Pearson coefficient. Result: The reliability of the pattern identification tool for benign prostatic hyperplasia was evaluated as “poor agreement beyond chance” (ICC=0.349). The reliability of each pattern identification score was evaluated as “good” for Yang Deficiency of Kidney, Yin Deficiency of Kidney, Deficiency of Middle Qi, and Dampness-heat of Lower Energizer. The internal consistency was evaluated as “good” for Yang Deficiency of Kidney, Yin Deficiency of Kidney, and Dampness-heat of Lower Energizer, and as “excellent” for Deficiency of Middle Qi. The correlation between pattern identification and IPSS was evaluated as a “moderate positive correlation” for all pattern identifications. The average flow rate and maximum flow rate using uroflowmetry was evaluated with “moderate negative correlation” for Yang Deficiency of Kidney and Dampness-heat of Lower Energizer. Conclusion: The reliability of a pattern identification tool for benign prostatic hyperplasia was evaluated as “poor agreement beyond chance.” Further research is needed.

A Novel Mobile Acoustic Uroflowmetry: Comparison With Contemporary Uroflowmetry

이영주,Michelle M. Kim,송상훈,이상철 대한배뇨장애요실금학회 2021 International Neurourology Journal Vol.25 No.2

Purpose: This study aimed to evaluate the accuracy and reliability of a new smartphone-based acoustic uroflowmetry compared to conventional uroflowmetry. Methods: This was a prospective validation study enrolling 128 subjects from September 2017 to April 2018 comparing a novel acoustic uroflowmetry to conventional uroflowmetry in an outpatient urologic clinic at Seoul National University Bundang Hospital. Visual comparison of flow patterns and uroflow parameters such as maximum flow rate (Qmax), average flow rate (Qavg), and voided volume were compared between the 2 techniques. Reliability and accuracy of the uroflowmetry results were compared using Pearson correlation coefficient (PCC) and Student t-test, respectively. Results: One hundred twelve participants were included in the study. Of these, 77 had baseline urologic comorbidities while 35 were normal participants. Flow patterns between the 2 uroflowmetry techniques demonstrated strong visual correlation. When compared to conventional uroflowmetry, all 3 parameters of voiding in male participants showed a very robust correlation with PCC of 0.88, 0.91, and 0.95 for Qmax, Qavg, and voided volume, respectively. Among female participants, we observed a PCC of 0.78, 0.93, and 0.96 for Qmax, Qavg, and voided volume, respectively. The Qmax showed a statistically significant difference in both sexes between the 2 methods, although the absolute value was small. Conclusions: Uroflowmetry using acoustic analysis demonstrates comparable findings to conventional uroflowmetry. This provides an opportunity to perform uroflowmetry in the clinic or at home in a reliable, inexpensive manner. Future large-scale prospective studies are required to further validate our results.

하부 요로 폐쇄에 대한 요류 역학적 연구

홍종우,최성협 인제대학교 1990 仁濟醫學 Vol.11 No.2

요류 측정술을 이용하여 전립선 비대증 환자 40례에서 경요도 전립선 절제술후 치료 효과를 평가하여 보고한다. Uroflowmetry has been proposed as a non-invasive screening test and may be used to reveal lower urinary tract dysfunctions, such as benign prostatic hyperplasia, urethral stricture and neurogenic bladder. We tested 40 patient of benign prostatic hyperplasia (BPH) diagnosed with clinical manifestations, IVP and cystoscopy. Group 1 including 15 patients performed both preoperative and postoperative uroflowmetry. Group 2 including 25 patients shown acute urinary retention preoperatively, performed only postoperative uroflowmetry. The results were obtained as follows. 1.In group 1, average preoperative maximum flow rate (MFR) was 7.2 cc/sec and postoperative MFR was 20.1 cc/sec (P<0.01). On flow rate normogram, preoperative MFR of all patients was below -2 standard deviations (SD) and average MFR was -3.1 SD. In postoperative MFR, below -2 SD values showed in 3 patient, -1 SD ~-2 SD in 6, -1 SD ~ mean in 4, above mean values in 2 and average MFR was -1.3 SD. 2.In Group 2, postoperative average MFR was 22.3cc/sec, below -2 SD values showed in 6 patients. -2 SD∼ -1 SD in 5, -1 SD - mean in 8, above mean values in 6 and average MFR was -0.93 SD. 3.MFR values of group 1 increased an average of 2.8 SD in each patient and 80% of patients were improved in uroflowmetry after transurethral resection of prostate (TURP). 4.If MFR of acute urinary retention was below -2 SD in group 2, 76% of patients were improved in uroflowmetry after TURP.

수압 측정에 기반하는 요류검사의 정확도 검증

최성수,이인광,김군진,강승범,박경순,이태수,차은종,김경아,Choi, Sung-Soo,Lee, In-Kwang,Kim, Kun-Jin,Kang, Seung-Bum,Park, Kyung-Soon,Lee, Tae-Soo,Cha, Eun-Jong,Kim, Kyung-Ah 대한의용생체공학회 2008 의공학회지 Vol.29 No.3

Uroflowmetry is a non-invasive clinical test useful for screening benign prostatic hyperplasia(BPH) common in the aged men. The current standard way to obtain the urinary flow rate is to continuously acquire the urine weight signal proportional to volume over time. The present study proposed an alternative technique measuring pressure to overcome noise problems present in the standard weight measuring technique. Experiments were performed to simultaneously acquire both weight and pressure changes during urination of 9 normal men. Noise components were separated from volume signals converted from both weight and pressure signals based on the polynomial signal model. Signal-to-noise ratio was defined as the ratio of the energies between signal and noise components of the measured volume changes, which was 8.5 times larger in the pressure measuring technique, implying that cleaner signal could be obtained, more immune to noisy environments. When four important diagnostic parameters were estimated, excellent correlation coefficients higher than 0.99 were resulted with mean relative errors less than 5%. Therefore, the present pressure measurement seemed valid as an alternative technique for uroflowmetry.

수압 요류검사의 정확도 검증

최성수,이인광,김성식,김경아,이태수,차은종 한국특허학회 2007 특허학연구 : 한국특허학회지 Vol.9 No.4

요류검사는 배뇨시 요의 유량을 비침습적으로 관찰하는 검사로 고령 남성의 대표적 질환인 전립선 비대증의 진단 및 관리에 유용하게 사용된다. 기존의 요류검사는 배뇨중 요(소변)의 무게를 로드셀(load cell)로 측정하여 요류신호를 산출하는데, 요 수집용기 바닥에서 무게를 측정하기 때문에 충격에 민감한 단점을 가지고 있다. 본 연구에서는 이를 극복하기 위해 수압 측정방식의 새로운 요류 계측방법을 제안하였으며, 수압 측정 방식의 요류검사로 산출한 진단매개변수를 기존의 무게 측정방식과 비교함으로써 정확도를 평가하고자 하였다. 건강한 성인 남성 9명을 대상으로 무게 및 수압 측정방식의 요류검사를 동시에 수행하여 용적신호를 산출한 후 잡음성분을 분리하였다. 두 용적신호에 대한 잡음성분의 비(signal-to-noise ratio)를 산출한 결과 수압 측정방식이 8.7배 더 크게 나타났다. 피검자별 요류신호로부터 산출한 4개의 진단 매개변수들을 무게 측정방식과 수압 측정방식 간에 선형 회귀분석하여 비교한 결과 모두 0.99 이상의 높은 상관관계를 나타내었다. 따라서 수압 측정방식의 새로운 요류검사 방법으로 정확한 진단 매개변수를 산출할 수 있음을 입증하였다. Uroflowmetry is a non-invasive clinical test useful for screening benign prostatic hyperplasia(BPH) common in the aged men. The standard way to obtain the urinary flow rate is to continuously measure the urine weight proportional to volume over time. The present study proposed an alternative technique measuring pressure to overcome noise problems present in the standard weight measurement. Experiments were performed to simultaneously acquire both weight and pressure changes during urination of 9 normal men. Noise components were separated from volume signals converted from both weight and pressure signals. Signal-to-noise ratio was defined as the ratio of the signal to noise power in volume changes, which was 8.5 times larger in the pressure measuring technique, implying that cleaner signal could be obtained, more immune to noisy environments. When four important diagnostic parameters were estimated, excellent correlation coefficients higher than 0.99 were resulted with mean relative errors less than 5%. Therefore, the present pressure measurement seemed valid as an alternative technique for uroflowmetry.

직장수지검사가 요류측정검사 결과에 미치는 영항

백승,소영석,노준,김철성,장대수 朝鮮大學校 附設 醫學硏究所 2004 The Medical Journal of Chosun University Vol.29 No.1

Background and Objectives : Digital rectal examination (DRE) and uroflowmetry have been usually together in the BPH management. The aim of this study was to determine whether DRE would affect uroflowmetry measurement. Materials and methods : A total of 80 male patients were included in this study. First uroflowmetry was done after DRE, second uroflowmetry was done without DRE. Third uroflowmetry was done after DRE, and fourth was done without DRE. Results : The mean Qmax on uroflowmetry after DRE was 15.2±8.7㎖/sec and 14.9±9.8㎖/sec. The mean Qmax on only uroflowmetry was 15.3±8.9㎖/sec and 15.4±8.4㎖/sec. There was statistically no difference between the mean Qmax(P> 0.05). And effect of digital rectal examination on uroflowmetry measurement with age was statistically no difference between the mean Qmax(P)0.05). Conclusions : We could not find and effect of DRE on uroflowmetry parameters, In this study, uroflowmetry test would be appropiate for recommending DRE before or after.

요도하열 교정술 후 요속 검사의 의의

윤재영,이현보,정석영 大韓泌尿器科學會 1998 Korean Journal of Urology Vol.39 No.5

전립선염증후군 환자에서 배뇨증상점수와 요속검사의 유용성

정도영,이정구,김영수 大韓泌尿器科學會 1998 Korean Journal of Urology Vol.39 No.3

전립선 진단을 위한 수압 측정 방식의 새로운 요 유량 계측기법

김경아 ( Kyung Ah Kim ),최성수 ( Sung Soo Choi ),차은종 ( Eun Jong Cha ) 한국센서학회 2007 센서학회지 Vol.16 No.3

소아 요류 측정술

이헌성,최환식,강상재 인제대학교 1993 仁濟醫學 Vol.14 No.4

소아요류의 정상치에 관한 정확한 설정을 위하여 부산시내 소재 국민 학생들을 대상으로 소아요류를 측정하였다. 이것은 소아배뇨장애환자의 치료 전후에 치료여부 및 효과판정에 유용할 것으로 사료된다. The uroflowmetry was performed in 135 normal male children between seven to thirteen years old, and the volume voided, voiding time, average and maximal flow rate were obtained as follow. 1.Volume voided, average and maximum flow rate were higher according to increasement of age and body weight. 2.Voding curves indicating the relationship between urinary flow and voided volume were obtained with logarithmic transformation.