Clinical Significance of Periurethral Calcification According to the Location in Men With Lower Urinary Tract Symptoms and a Small Prostate Volume

Abstract

Purpose:To assess the impact of periurethral calcification (PUC) according to its location on uroflowmetric parameters and urinary symptoms in patients with small prostate volume (PV). Methods: Records were obtained from a prospectively maintained database of first-visit men with lower urinary tract symptoms (LUTS). Patients whose PV was > 30 mL were excluded to elucidate more clearly the impact of PUC on LUTS. A total of 539 patients were enrolled in the study. The prostatic urethra was examined by transrectal ultrasonography for PUC, and the location of PUC was divided into 3 areas (proximal, mid, and distal). Results: The characteristics according to the location of PUC were compared using a 1-way analysis of variance test. The Total International Prostate Symptom Score (IPSS), postmicturition symptoms, and overactive bladder symptom score (OABSS) differed significantly among the groups. In the propensity score matching analysis, the proximal-and distal-PUC groups did not have a significantly different urinary flow rate or symptom score when compared to their matched control groups. However, the mid-PUC group had significantly worse urinary symptoms than its matched control group (total IPSS [P = 0.001], voiding symptoms [P = 0.002], storage symptoms [P = 0.041], and OABSS [P = 0.015]). The peak urinary flow rate was also lower in the mid-PUC group with borderline significance (P = 0.082). On multivariate linear regression analysis, mid-PUC was independently associated with IPSS and OABSS (P = 0.035 and P = 0.011, respectively). Conclusions: Only mid-PUC was associated with symptom severity in men with LUTS and a small PV. Our findings suggest that mid-PUC could be a potential causal factor of LUTS, and the midportion of the prostatic urethra might play a pivotal role in the process of micturition.

Resveratrol reduces inflammation-related Prostate Fibrosis

“…In these patients, the co-presence of multiple prostatic calcifications having larger prostatic calculi with the diameter over 3 mm has a pathological connection with prostatic inflammatory changes and fibrosis [29,30]. In particular, inflammation of the periurethral area, can contribute, via an excess of collagen deposition and fibrosis in the prostate, to impair urethral function, with urethral stiffness which in turn maximizes induction of LUTS [31][32].…”

“…• LUTS encompasses a wide range of symptoms, categorized by the International Continence Society (ICS) as storage, voiding, and postmicturition. The severity of LUTS was assessed using the IPSS, Each of the questions is rated from 0 (not at all) to 5 (almost always), and according to the total symptom score, the severity of LUTS can be graded as mild (0-7), moderate (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19) or severe (20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35), since a total IPSS ≥8 points was considered to indicate the presence of LUTS [18];…”

<p>Predictors Of Postoperative Lower Urinary Tract Symptoms Improvements In Patient With Small-Volume Prostate And Bladder Outlet Obstruction</p>

“…Previous studies have shown that the prostate volume is weakly correlated with LUTS2,6,20 in patients with a small-volume prostate and BOO. In the present study, neither TPV nor TZV was a predictor of postoperative Qmax, IPSS, IPSS-s, or IPSS-v improvement in patients with a small-volume prostate and BOO.…”

“…Therefore, other parameters reflecting the morphological features of the prostate, such as IPP, TZI, PUA, and PUB, were included in our study. These parameters are highly correlated with LUTS in patients with a small prostate 6,20,26. The aim of this study was to investigate the role of these quantitative morphological features in postoperative LUTS improvement in patients with small-volume prostates.…”

“…⑤An interest and ability to participate in this study. The exclusion criteria were as follows :13,20 ①postoperative pathology report for prostate cancer; ②history of diabetes; ③history of prostate tumor or bladder tumor; ④history of bladder calculi, neurogenic bladder, chronic prostatitis, urethral calculi, chronic cystitis, urethral stricture, or hypospadias; ⑤history of prostate biopsy; ⑥history of lower urinary tract surgery or pelvic radiation therapy; ⑦uncured postoperative urinary tract infection; ⑧history of medication affecting LUTS during follow-up; ⑨postoperative bladder neck stenosis. Initially, a total of 257 patients (including 111 TURP patients, 146 PKEP patients) were enrolled in this study when followed up to 3 months after surgery.…”