Is intravesical prostatic protrusion associated with more complications in benign prostatic hyperplasia patients?

Abstract

Objective Intravesical prostatic protrusion (IPP) is a noninvasive parameter that can predict disease progression and development of complications in benign prostatic hyperplasia (BPH). This study was to determine the relationship between IPP and the presence of complications in BPH patients. Methods This was a cross‐sectional study of BPH patients at Enugu State University of Science and Technology Teaching Hospital, Enugu. Patients were assessed for acute urinary retention (AUR), chronic urinary retention (CUR), epididymoorchitis, hematuria, hernia, urinary tract infection (UTI), serum creatinine, and prostate‐specific antigen (PSA). They also had abdominal ultrasonography assessments for IPP, total prostate volume, bladder wall thickness (BWT), postvoid residual (PVR), hydronephrosis, bladder diverticulum, and urolithiasis using Sonoscape S11 with an abdominal‐probe frequency of 3.5 MHz. IPP was measured in millimeter and divided into <10 mm and ≥10 mm. Data were analyzed using SPSS version 21 and were subjected to 1‐way analysis of variance, chi‐square test, and Pearson correlation. The odds ratios of development of complications at an IPP cutoff of 10 mm were calculated. P < .05 was considered significant. Results A total of 118 patients with a mean age of 64.18 ± 10.96 years and a mean IPP of 14.29 ± 10.20 mm were included. Forty‐eight patients had IPP < 10 mm and seventy patients ≥10 mm. Patients with IPP ≥10 mm had significantly higher mean BWT, International Prostate Symptom Score (IPSS), PSA, and PVR (P ≤ .05) and significantly more AUR, CUR, hematuria, hydronephrosis, and UTI (P ≤ .01). Conclusion Patients with IPP ≥ 10 mm have a significantly higher incidence of some complications.

Correlation between Initial International Prostate Symptom Score (IPSS) and Complications of Benign Prostatic Hyperplasia

“…All of the studies cited above have shown that higher IPSS correlated with many factors, which indicated more severity of BPH symptoms. Moreover, there are many reports of an association between factors relating to BPH severity; such as intravesical prostatic protrusion 11 , post-void residual urine 2 , prostate volume 12 , the elevation of PSA level 12 and complications of BPH. From the studies above, IPSS may be expected to predict severity the and complications of BPH.…”

“…Each question has zero to five points (0 as no symptom to 5 as almost always suffering from symptoms). The summation of IPSS will classify the severity of symptoms into three groups: mild (0-7), moderate (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19) and severe (20-35). The sample size in this study was determined by the detection of a 5% difference in the prevalence of BPH in Thailand, with 5% α-error, 20% β-error and 80% power of test.…”

Can we predict whether a man with acute or chronic urinary retention will void after bladder outflow resistance reduction surgery? ICI‐RS 2023

“…IPP > 10 mm appears to be associated with more BOO on UDS examination, higher IPSS, higher postvoid residual and a higher rate of acute UR. 20,21 Finally, and surprisingly, although some studies have attempted to determine which urodynamic parameters may predict outcomes after BORRS, there are no robust data from prospective studies identifying UDS parameters, particularly ICS-BOO index (ICS-BOOI) and ICS detrusor contractility index (ICS-DCI) as independent predictors of acute UR or of the need for surgery. This is likely due to the multifactorial nature of the risk for acute UR.…”

Transurethral plasmakinetic resection versus enucleation for benign prostatic hyperplasia: comparison of intraoperative safety profiles based on endoscopic surgical monitoring system

“…A previous study suggested more than half of men with age over 60 years old showed symptoms associated with BPH [ 2 ]. As the disease progresses, symptoms such as hematuria, urinary system infection, urinary calculus and bladder decompensation may occur [ 3 ]. Currently, many surgical methods are available for the treatment of BPH, such as transurethral resection of the prostate (TURP), simple prostatectomy, transurethral laser vaporization and enucleation [ 4 ].…”