scholarly journals Comparison between prostate volume and intravesical prostatic protrusion in detecting bladder outlet obstruction due to benign prostatic hyperplasia

2012 ◽  
Vol 38 (1) ◽  
pp. 14-17 ◽  
Author(s):  
AKMS Hossain ◽  
AKMK Alam ◽  
AKMK Habib ◽  
MM Rashid ◽  
H Rahman ◽  
...  
Keyword(s):  
Benign Prostatic Hyperplasia ◽  
Bladder Outlet Obstruction ◽  
Prostate Volume ◽  
Digital Rectal Examination ◽  
Outlet Obstruction ◽  
Rank Correlation ◽  
Roc Curves ◽  
Prostatic Hyperplasia ◽  
Transabdominal Ultrasonography ◽  
Intravesical Prostatic Protrusion

The objectives of this study were to determine and compare the correlation of intravesical prostatic protrusion (IPP) and prostate volume (PV) with bladder outlet obstruction (BOO). This study was conducted in the department of urology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh, between July 2009 to September 2010. Fifty benign prostatic hyperplasia (BPH) patients were included in the study. Their evaluation consisted of history along with International Prostate Symptoms Score (IPSS), digital rectal examination (DRE), transabdominal ultrasonography to measure prostate volume, intravesical prostatic protrusion & post voidal residual (PVR) urine and pressure-flow studies to detect bladder outflow obstruction (BOO). Statistical analysis included Unpaired ‘t’ test, Chisquare test and Spearman’s Rank correlation test. Receiver Operator Characteristic (ROC) curves were used to compare the correlation of PV and IPP with BOO. Mean prostate volume was significantly larger in bladder outlet obstructed patients (P<0.05). Mean IPP was significantly greater in obstructed patients (P<0.001). Area under ROC curve was 0.700 for PV and 0.821 for IPP. Prostate volume & intravesical prostatic protrusion measured through transabdominal ultrasonography are noninvasive and accessible method that significantly correlates with bladder outlet obstruction in patients with benign prostatic hyperplasia and the correlation of IPP is much more stronger than that of prostate volume. Introduction Benign prostatic hyperplasia (BPH) is one of the most common diseases in elderly men. The prevalence of histological BPH increases with age and appears in approximately 40% of men aged 50- 60 years and in approximately 90% of men aged more than 80 years1. Benign prostatic hyperplasia may lead to prostatic enlargement, bladder outlet obstruction (BOO) and lower urinary tract symptoms (LUTS). But the symptoms and obstruction do not entirely depend on prostate’s size. In contrast, intravesical prostatic protrusion (IPP) has been found to correlate with BOO2. IPP is a morphological change due to overgrowth of prostatic median and lateral lobes into the bladder and may lead to diskinetic movement of bladder during voiding. This IPP would cause more obstruction than if there were no protrusion and just enlargement of lateral lobes, as the strong bladder contraction could force open a channel between the lobes3. Several studies have previously demonstrated that the ultrasonographic measurement of IPP is able to detect BOO in BPH patients quickly and non-invasively4. This study was designed to diagnose BOO through non-invasive methods and aimed to define the correlationDOI: http://dx.doi.org/10.3329/bmrcb.v38i1.10446  Bangladesh Med Res Counc Bull 2012; 38: 14-17

scholarly journals Clinical Considerations for Intravesical Prostatic Protrusion in the Evaluation and Management of Bladder Outlet Obstruction Secondary to Benign Prostatic Hyperplasia

2018 ◽  
Vol 12 (1) ◽  
pp. 6-12 ◽  
Author(s):  
Jason Gandhi ◽  
Steven J. Weissbart ◽  
Albert N. Kim ◽  
Gunjan Joshi ◽  
Steven A. Kaplan ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Benign Prostatic Hyperplasia ◽  
Lower Urinary Tract Symptoms ◽  
Bladder Outlet Obstruction ◽  
Lower Urinary Tract ◽  
Outlet Obstruction ◽  
Prostatic Hyperplasia ◽  
Urinary Tract Symptoms ◽  
Intravesical Prostatic Protrusion ◽  
Lower Urinary

Background: Intravesical prostatic protrusion (IPP) is a manifestation of benign prostatic hyperplasia marked by overgrowth of the prostatic median lobe into the bladder, producing bladder outlet obstruction and related storage and voiding symptoms. Methods: A MEDLINE® database search of the current literature was guided using combination of “prostate” with the following terms: intravesical prostatic protrusion, bladder trabeculation, bladder outlet obstruction, lower urinary tract symptoms, alpha blockers, transrectal ultrasonography, and prostatectomy. Results: Although IPP can be identified via a variety of imaging modalities, it is easily detected via transrectal ultrasonography (TRUS). Failing to detect IPP promptly by TRUS may result in refractory symptoms of benign prostatic hyperplasia, as the condition may not respond to typical α1-adrenoceptor antagonist therapy. In addition, depending on grade, IPP can influence outcomes and complications of prostatectomies. Conclusion: Upon report of lower urinary tract symptoms, initial performance of TRUS along with digital rectal examination prevents delay in the appropriate evaluation and management of prostatic diseases.

scholarly journals CORRELATION BETWEEN PROSTATIC URETHRAL ANGLE WITH CLINICAL PARAMETERS AND BOO IN LUTS ASSOCIATED WITH BPH

2013 ◽  
Vol 20 (1) ◽  
Author(s):  
Kristian Yoci Santoso Yoci Santoso ◽  
Doddy M. Soebadi ◽  
Wahjoe Djatisoesanto ◽  
Budiono Budiono
Keyword(s):  
Urinary Tract ◽  
Benign Prostatic Hyperplasia ◽  
Bladder Outlet Obstruction ◽  
Lower Urinary Tract ◽  
Prostate Volume ◽  
Outlet Obstruction ◽  
Prostatic Hyperplasia ◽  
Clinical Parameters ◽  
Urinary Tract Symptoms ◽  
Lower Urinary

Objective: We investigated the correlation of the PUA on clinical parameters and bladder outlet obstruction (BOO) in men with lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH). Material & Method: This study was performed between January to April 2011. A cross sectional analysis of 24 men with LUTS associated BPH aged > 50 years was performed. Patients underwent evaluation including International Prostatic Symptom Score (IPSS), transrectal ultrasonography, uroflowmetry, and pressure-flow study. Statistical analysis was performed to evaluate correlation of the PUA on clinical parameters and bladder outlet obstruction (BOO). Results: A total of 24 patients, aged 51 to 78 years were enrolled in this study. The mean value of total IPSS, prostate volume, PUA, and Qmax was 22 (range 7-35), 34,4 cm3 (range 21–70 cm3), 37,3° (range 25°–55°), and 10,5 mL/s (range 4,2–17,9 mL/s), respectively. Pearson’s correlation analysis showed that PUA was not significantly correlated with IPSS (p = 0,117), Qmax (p = 0,434), total prostate volume (p = 0,213). Patients with increased PUA (PUA > 35°) had higher incidence and degree of BOO (p < 0,05). Conclusion: PUA may be one method to assess the presence of BOO in men with LUTS associated BPH. Our investigation suggest that PUA may help in the treatment of individuals by better predicting their likely classification from a pressure-flow study.Keywords: Prostatic urethral angle, benign prostatic hyperplasia, lower urinary tract symptoms, bladder outlet obstruction.

scholarly journals CORRELATION OF PSA, PV, AND IPP IN DETECTING BOO CAUSED BY PROSTATE ENLARGEMENT

2014 ◽  
Vol 21 (2) ◽  
Author(s):  
Indra Cahya Kurnia ◽  
Tanaya Ghinorawa ◽  
Sungsang Rochadi
Keyword(s):  
Prostate Specific Antigen ◽  
Bladder Outlet Obstruction ◽  
Prostate Volume ◽  
Specific Antigen ◽  
Outlet Obstruction ◽  
Roc Curves ◽  
Transabdominal Ultrasound ◽  
Prostate Hyperplasia ◽  
Predictive Values ◽  
Intravesical Prostatic Protrusion

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.

scholarly journals Correlation of intravesical prostatic protrusion with severity of lower urinary symptoms among patients with benign prostatic hyperplasia

2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Babatunde K. Hamza ◽  
Muhammed Ahmed ◽  
Ahmad Bello ◽  
Musliu Adetola Tolani ◽  
Mudi Awaisu ◽  
...  
Keyword(s):  
Flow Rate ◽  
Bladder Outlet Obstruction ◽  
Peak Flow ◽  
Prostate Volume ◽  
Outlet Obstruction ◽  
Peak Flow Rate ◽  
The Mean ◽  
Benign Prostate ◽  
Intravesical Prostatic Protrusion ◽  
Lower Urinary

Abstract Background Benign prostate hyperplasia (BPH) is characterized by an increase in the number of epithelial and stromal cells in the periurethral area of the prostate. Lower urinary tract symptoms (LUTS) often develop as a manifestation of bladder outlet obstruction (BOO) due to benign prostate enlargement. When the prostate enlarges, protrusion into the bladder often occurs as a result of morphological changes of the gland. Prostatic protrusion into the bladder can be measured with ultrasound as intravesical prostatic protrusion (IPP). There are studies that have shown IPP as a reliable predictor of bladder obstruction index (BOOI) as measured by pressure flow studies. IPP is thereby reliable in assessing the severity of BOO in patients with BPH. The severity of symptoms in patients with BPH can be assessed through several scoring systems. The most widely used symptoms scoring system is the International Prostate Symptoms Score (IPSS). The aim of this study is to determine the correlation of IPP with IPSS in men with BPH at our facility. Methods The study was a cross-sectional observational study that was conducted at the Division of Urology, Department of Surgery, in our facility. The study was conducted on patients greater than 50 years LUTS and an enlarged prostate on digital rectal examination and/or ultrasound. All consenting patients were assessed with the International Prostate Symptoms Score (IPSS) questionnaire, following which an abdominal ultrasound was done to measure the intravesical prostatic protrusion (IPP), prostate volume (PV) and post-void residual (PVR) urine. All the patients had uroflowmetry, and the peak flow rate was determined. The data obtained were entered into a proforma. The results were analyzed using Statistical Package for Social Sciences (SPSS) software package version 20. Results A total of 167 patients were seen during the study period. The mean age was 63.7 ± 8.9 years, with a range of 45–90 years. The mean IPSS was 18.24 ± 6.93, with a range of 5–35. There were severe symptoms in 49.1%, while 43.1% had moderate symptoms and 7.8% had mild symptoms. The overall mean IPP was 10.3 ± 8 mm. Sixty-two patients (37.1%) had grade I IPP, 21 patients (12.6%) had grade II IPP and 84 patients (50.3%) had grade III IPP. The mean prostate volume and peak flow rate were 64 g ± 34.7 and 11.6 ml/s ± 5.4, respectively. The median PVR was 45 ml with a range of 0–400 ml. There was a significant positive correlation between the IPP and IPSS (P = 0.001). IPP also had a significant positive correlation with prostate volume and post-void residual and a significant negative correlation with the peak flow rate (P < 0.01). Conclusion Intravesical prostatic protrusion is a reliable predictor of severity of LUTS as measured by IPSS, and it also shows good correlation with other surrogates of bladder outlet obstruction.

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