Objective: To evaluate some parameters as the predictors of urine retention incident in Benign Prostate Hyperplasia (BPH) patients. Materials & Methods: From May to August 2012, a total of 24 BPH patients aged 47-69 years with lower urinary tract symptomps (LUTS) including 12 patients with urine retention were participated in the study. Prostate specific antigen (PSA) examination was performed on all patients. For urine retention patients, PSA was performed 2 weeks after catheterization as the procedure may affect PSA levels. Transrectal ultrasonography (TRUS) was examined to assess total prostate volume (VTP), transitional zone volume (VZT), transitional zone index (IZT = VZT / VTP), and resistive index of prostate capsulary arteries. Statistic was utilized using simple and multiple logistic regression. Receiver operating characteristic (ROC) was calculated to assess the usefulness of parameters as a predictor of urine retention. Results: There was no significant difference in age between LUTS and BPH patients with urine retention (p = 0,487). There was no relationship between PSA and transitional zone index to incidence of urine retention in BPH patients (PSA; p = 0,173 and TZI; p = 0,192). Multiple logistic regression analysis showed only resistive index of prostate capsulary arteries which correlates with urine retention incidence (p = 0,014), with area under ROC 0,865 (95% CI 0,721 to 1,008) and cut-off value of > 0,675 as a predictor of urine retention incidence. Conclusion: Resistive index of prostate capsulary arteries by transrectal ultrasonography (TRUS) is a predictor of urine retention incidence in BPH patients.Key words: prostate specific antigen, transitional zone index, resistive index of prostate capsulary arteries, benign prostate hyperplasia, lower urinary tract symptoms, urine retention.
McVary KT. BPH: Epidemiology and comorbidities. The American Journal of Managed Care. 2006; 12: S122-8.
Milonas D, Trumbeckas D. Prostate-specific antigen and transition zone index–powerful predictors for acute urinary retention in men with benign prostatic hyperplasia. Medicina. 2003; 39(11): 1071-7.
Roehrborn CG, McConnell JD, Lieber M, Kaplan S, Geller J, Malek GH, et al. Serum prostate-specific antigen concentration is a powerful predictor of acute urinay retention and need for surgery in men with clinical benign prostatic hyperplasia. Urology. 1999; 53: 374-480.
Shinbo H, Kurita Y, Takada S, Imanishi T, Otsuka A, Furuse H, et al. Resistive index as risk factor for acute urinary retention for patient with benign prostatic hyperplasia. Urology. 2010; 76(6): 1440-5.
McNicholas TA, Kirby RS, Lepor H. Evaluation and nonsurgical management of benign prostatic hyperplasia. In: Wein AJ, Kavoussi LR, Novick AC, Partin AW, Peters CA, editors. Campbell-Walsh Urology. 10th ed. Philadelphia: Saunders Elsevier; 2012. p. 2597-640.
Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U, et al. The standardization of terminology of lower urinary tract function: Report from the standardization sub-committee of the international continence society. Neurourology Urodynamic. 2002; 21: 167-78.
Abrams P, Belal M. Noninvasive methods of diagnosing bladder outlet obstruction in men. Part 1: Nonurodynamic Approach. The Journal of Urology. 2006; 176: 22-8.
Jacobsen SJ, Jacobsen DJ, Girman CJ, Roberts RO, Rhodes T, Guess HA, et al. Natural history of prostatism: Risk factors for acute urinary retention. J Urol. 1997; 158: 481-7.
Roehrborn CG, Boyle P, Gould AL, Waldstreicher J. Serum prostate-specific antigen as a predictor of prostate volume in men with benign prostatic hyperplasia. Urology. 1999; 53: 581-9.
Aliasgari M, Soleimani M, Moghaddam SMH. The effect of acute urinary retention on serum prostate-specific antigen level. Urology Journal. 2005; 2(2): 89-92.
McNeal J. Pathology of benign prostatic enlargement. Urol Clin North Am. 1978; 17: 477-86.
Kaplan SA, Te AE, Pressler LB, Olsson CA. Transition zone index as a method assessing benign prostatic hyperplasia: Correlation with symptoms, urine flow, and detrusor pressure. The Journal of Urology. 1995; 154: 1764-9.
Kurita Y, Masuda H, Terada H, Suzuki K, Fujita K. Transition zone index as a risk factor for acute urinary retention in benign prostatic hyperplasia. Adult Urology. 1998; 51: 595-600.
Masumori N, Tsukamoto T, Kumamoto Y, Miyake H, Rhodes T, Girman CJ, et al. Japanese men have smaller prostate volume but comparable urinary flow rates relative to American men: Results of community based studies in 2 countries. The Journal of Urology. 1996; 155: 1324-7.
Tsuru N, Kurita Y, Masuda H, Suzuki K, Fujita K. Role of Doppler ultrasound and resistive index in benign prostatic hypertrophy. International Journal of Urology. 2002; 9: 427-30.
Tsuru N, Kurita Y, Suzuki K. Resistance index in benign prostatic hyperplasia using power Doppler imaging and clinical outcomes after transurethral vaporization of the prostate. International Journal of Urology. 2005; 12: 264-9.