Correlation of Psa, Pv, and Ipp in Detecting Boo Caused by Prostate Enlargement

Abstract

Objective: To define the relationship between intravesical prostatic protrusion (IPP), prostate specific antigen (PSA), and prostate volume (PV), and to determine which one is the best predictor of bladder outlet obstruction (BOO) due to benign prostatic enlargement. Material & method: 95 male patients > 40 years old presenting with LUTS and BPH, between January until July 2012. They were evaluated with digital rectal examination (DRE), International Prostate Symptoms Score (IPSS), total PSA serum, uroflowmetry, post-void residual urine measurement, IPP and PV using transabdominal ultrasound. Statistical analysis included Chi-square and Spearman’s Rank correlation test.Receiver Operator Characteristic (ROC) curves were used to evaluate the correlation of PSA, PV, and IPP with BOO. Results: Mean PSA was significantly higher in obstructed patients (8.6 ng/mL; 0.76-130) compared to non-obstructed patients (6.44 ng/mL; 1.0-40.6). Mean PV was significantly larger in obstructed patients (50.33 mL ± 24.34) compared to non-obstructed patients (45.39 mL ± 23.43). Mean IPP was significantly greater in obstructed patients (7.29 ± 2.78) compared to non-obstructed patients (6.59 ± 2.93). The Spearman rho correlation coefficients were 0.617, 0.721, and 0.797, for PSA, PV, and IPP, respectively. Using ROC curves, the areas under the curve for PSA, PV, and IPP were 0.509, 0.562 and 0.602, respectively. The positive predictive values of PV, PSA, and IPP were 59.7%, 55.6% and 60.2% respectively. Conclusion: PSA, PV, and IPP measured through transabdominal ultrasonography are noninvasive and accessible method that significantly correlates with BOO in BPH patients. IPP is a better predictor for BOO than PSA or PV.Keywords: Bladder outlet obstruction, intravesical prostatic protrusion, prostate specific antigen, prostate volume, transabdominal ultrasound, benign prostate hyperplasia.

Evaluation of the Accuracy of the Use of Intravesical Prostatic Protrusion Degree as the Predictor of Benign Prostatic Hyperplasia Management

“…2 It has been confirmed to be a better predictor of bladder outlet obstruction (BOO) than prostate specific antigen (PSA) or prostate volume (PV). 5 There are some modalities to measure IPP including ultrasound, magnetic resonance imaging, computed tomography scan and flexible cystoscope, but it can't be well identified by traditional digital rectal examination (DRE) and bimanual palpation of bladder. 2 Ultrasound measurement of intravesical prostatic protrusion (IPP) provides superior diagnostic value in bladder outlet obstruction (BOO) compared to total prostate volume (TPV) and numerous other non-invasive assessments.…”

“…8 Although they relate well each other, IPP has better value than PV and PSA. 5,8 The grade of IPP is correlated to the clinical progression of BPH and urodynamic evidence of BOO. 12 The study shows further evidence that IPP influences BOO independently.…”