Summary
The present discussion on the natural history, growth rate, pathophysiology, morbidity, and possible treatment of benign prostatic hyperplasia (BPH) reinforces the need to objectify mechanical BPH-induced obstruction with pressure-flow study. Different methods for the quantification of BPH-induced obstruction exist and the grade of simplification depends on their working mechanism. To review the limitations of the current concepts, 118 BPH patients were selected for computerized pressure-flow data analysis according to quadratic passive urethral resistance relation (PURR) function. The CHESS classification differs from all other concepts due to its two-dimensional character and was developed as a result of the following way of thinking: (1) the whole individual pressure-flow plot is the most accurate basis for further analysis; (2) PURR as the true low-pressure flank of the individual plot is the most favorable definition for mechanical obstruction; (3) PURR quantification requires at least two parameters, footpoint and curvature/slope, with regard to the documented missing significant correlation of both; and (4) a two-parameter-based classification is two-dimensional (CHESS classification).
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Höfner, K., Kramer, A.E.J.L., Tan, H.K. et al. CHESS classification of bladder-outflow obstruction. World J Urol 13, 59–64 (1995). https://doi.org/10.1007/BF00182667
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DOI: https://doi.org/10.1007/BF00182667