ULTRASOUND-BASED PROSTATE VOLUME ESTIMATION AND ITS CORRELATION WITH POST-VOID RESIDUAL, PSA LEVELS, AND IPSS IN MEN WITH LOWER URINARY TRACT SYMPTOMS
DOI:
https://doi.org/10.71000/njs1g425Keywords:
International Prostate Symptom Score, Lower Urinary Tract Symptoms, Post-Void Residual Urine, Prostate Volume, Prostate-Specific Antigen, Ultrasonography, Urologic DiseasesAbstract
Background: Lower urinary tract symptoms (LUTS) are frequently observed in aging men and are commonly associated with benign prostatic hyperplasia (BPH). Accurate estimation of prostate volume is essential in diagnosing and managing BPH and related conditions. Ultrasonography offers a non-invasive, accessible, and cost-effective method for evaluating prostate size and related urinary parameters such as post-void residual (PVR) urine, prostate-specific antigen (PSA) levels, and symptom severity as per the International Prostate Symptom Score (IPSS).
Objective: To evaluate the utility of transabdominal ultrasonography in estimating prostate volume in male patients with LUTS and its correlation with PVR urine, PSA levels, and IPSS.
Methods: This cross-sectional analytical study was conducted at the District Head Quarter Hospital, Chiniot, Pakistan, from February to June 2024. A total of 158 male patients aged above 40 years presenting with LUTS were included using non-probability sampling. Exclusion criteria included prior pelvic or prostatic surgery, urethral pathologies, and urinary tract stones. Transabdominal ultrasonography was performed using 2–5 MHz and 7.5–10 MHz probes to measure prostate volume and post-void residual urine. IPSS scores and serum PSA levels were also recorded. Data were analyzed using SPSS version 24.0.
Results: The mean age of participants was 55.48 ± 12.58 years. Average prostate volume was 65.39 ± 23.57 cc, mean PSA level was 6.2 ± 5.34 ng/mL, and mean PVR urine volume was 73.35 ± 37.81 mL. IPSS scores indicated 25.9% had mild symptoms, 41.8% moderate, and 32.3% severe. A weak correlation was found between age and prostate volume (r = 0.104, p = 0.191), while strong positive correlations were observed between prostate volume and IPSS (r = 0.779, p < 0.001), PSA (r = 0.699, p < 0.001), and a moderate correlation with PVR (r = 0.575, p < 0.001).
Conclusion: Ultrasonography proved to be a valuable tool in assessing prostate volume and its significant correlations with PSA levels, IPSS, and PVR urine. These associations support its clinical use in evaluating and managing LUTS in aging males.
References
de Assis AM, Moreira AM, Carnevale FC, Zafred Marcelino AS, Antunes AA, Srougi M, et al. Role of Ultrasound Elastography in Patient Selection for Prostatic Artery Embolization. J Vasc Interv Radiol. 2021;32(10):1410-6.
Park JS, Lee D, Koo KC, Chung BH, Lee KS. The role of prostatic apex shape in voiding symptoms and urine flow: an exploratory and confirmatory study. World J Urol. 2020;38(5):1275-82.
Zhang R, Singh S, Pan C, Xu B, Kindblom J, Eng KH, et al. Rate of castration-induced prostate stroma regression is reduced in a mouse model of benign prostatic hyperplasia. Am J Clin Exp Urol. 2023;11(1):12-26.
Tian Y, Liu HM, Yang B, Yang XS, Sun ZL, Sun F, et al. Prostatic anatomical parameters correlate with clinical characteristics suggestive of benign prostatic hyperplasia. Asian J Androl. 2021;23(1):64-8.
Schifano N, Capogrosso P, Matloob R, Boeri L, Candela L, Fallara G, et al. Patients presenting with lower urinary tract symptoms who most deserve to be investigated for primary bladder neck obstruction. Sci Rep. 2021;11(1):4167.
Eze BU, Ani CO, Mbaeri TU. Is intravesical prostatic protrusion associated with more complications in benign prostatic hyperplasia patients? Low Urin Tract Symptoms. 2021;13(4):468-74.
Frego N, Saita A, Casale P, Diana P, Contieri R, Avolio PP, et al. Feasibility, safety, and efficacy of ultrasound-guided transperineal laser ablation for the treatment of benign prostatic hyperplasia: a single institutional experience. World J Urol. 2021;39(10):3867-73.
Salar R, Erbay G. Effect of alpha-blocker use on morbidity and lower urinary tract symptoms in patients undergoing transrectal ultrasound-guided prostate biopsy. Urologia. 2022;89(4):541-6.
Oelke M, Abt SD, Becher KF, Dreikorn K, Madersbacher S, Magistro G, et al. [Diagnostic work-up of benign prostatic hyperplasia : The German S2e-guideline 2023 part 1]. Urologie. 2023;62(8):805-17.
Anzia LE, Johnson CJ, Mao L, Hernando D, Bushman WA, Wells SA, et al. Comprehensive non-invasive analysis of lower urinary tract anatomy using MRI. Abdom Radiol (NY). 2021;46(4):1670-6.
Li Y, Chen Z, Zeng R, Huang J, Zhuo Y, Wang Y. Bladder Neck Angle Associated with Lower Urinary Tract Symptoms and Urinary Flow Rate in Patients with Benign Prostatic Hyperplasia. Urology. 2021;158:156-61.
Liu, D.; Shoag, J.E.; Poliak, D.; Goueli, R.S.; Ravikumar, V.; Redmond, D.; Vosoughi, A.; Fontugne, J.; Pan, H.; Lee, D.; et al. Integrative multiplatform molecular profiling of benign prostatic hyperplasia identifies distinct subtypes. Nat. Commun. 2020, 11, 1987.
Eze BU, Mbaeri TU, Orakwe JC. Anterior bladder wall thickness, post-void urine residue, and bladder emptying efficiency as indicators of bladder dysfunction in Nigerian men with benign prostatic hyperplasia. Niger J Clin Pract. 2020 Sep;23(9):1215-20.
Hamid SH, Mohamedahmed AY, Sharfi AR. Correlation between the size of the prostate, post void residual volume, PSA level and IPSS in Men with LUTS in three major Urology centres in Khartoum. Int J Surg Res. 2020;9(1):1-8.
McVary KT, Kaplan SA. A Tower of babel in today's urology: disagreement in concepts and definitions of lower urinary tract symptoms/benign prostatic hyperplasia re-treatment. J Urol. 2020;204:213–214.
Awaisu, M., Ahmed, M., Lawal, A. T., Sudi, A., Tolani, M. A., Oyelowo, N., Muhammad, M. S., Bello, A., & Maitama, H. Y. (2021). Correlation of prostate volume with severity of lower urinary tract symptoms as measured by international prostate symptoms score and maximum urine flow rate among patients with benign prostatic hyperplasia. African Journal of Urology, 27(16).
Munsif, T., Haider, S. S., Tewari, V., Fatima, M., & Sharma, P. K. (2021). Ultrasonographic study of comparison of prostate volume and post void residual urine with age in North Indian population. Asian Journal of Medical Sciences, 12(10), 27-33.
Shakya N, Upadhyay PK, Nepal B, Sthapit R, Shrestha A, Bhatta N, Shrestha S. Relationship between Lower Urinary Tract Symptoms measured by International Prostate Symptom Score and Prostate Volume. Medical Journal of Pokhara Academy of Health Sciences. 2023 Jul 9;6(1):508-11.
Mbouché LO, Mbassi AA, Ngallè FG, Ako F, Makon AS, Moifo B, Angwafo III F. Correlation between the International Prostate Symptom Score, ultrasound features and maximum flow rate in Cameroonian patients with benign prostatic hypertrophy. Open Journal of Urology. 2022 Jan 10;12(1):37-50.
Gurjar OP, Arya R, Goyal H. A study on prostate movement and dosimetric variation because of bladder and rectum volumes changes during the course of image-guided radiotherapy in prostate cancer. Prostate international. 2020 Jun 1;8(2):91-7.
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