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

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Published 2014-07-03
Indra Cahya Kurnia Tanaya Ghinorawa Sungsang Rochadi

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.


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References

Presti JC, Kane CJ, Shinohara K, Carrol PR. Neoplasm of the prostate gland. In Smith's General Urology, 17th. McGrawHill; 2008. p. 348-55.

Byung Ha Chung, Sung Joon Hong, Jin Seon Chom, Do Hwan Seong. Relationship between serum prostate specific antigen and prostate volume in Korean men with benign prostatic hyperplasia: a multicentre study. BJU Int. 2006; 97: 742-6.

Sang Eun Lee, Jae Seung Chung, Byung Kyu Han, Ki Hyuk Moon, Sung Il Hwang, Hak Jong Lee, et al. Relationship of prostate specific antigen and prostate volume in Korean men with biopsy-proven benign prostatic hyperplasia. Urology. 2008; 71: 395-8.

CA Mochtar, LALM. Kiemeney, MM van Riemsdijk, GS Barnett, MP Laguna, FMJ Debruyne, et al. Prostate specific antigen as an estimator of prostate volume in the management of patients with symptomatic benign prostatic hyperplasia. Eur Urol. 2003; 44: 695-700.

Zhang Keqin, Xu Zhishun, Zhang Jing, Wang Haixin, Zhang Dongqing, Shi Benkang. Clinical significance of intravesical prostatic protrusion in patients with benign prostatic enlargement. Urology. 2007; 70: 1096-9.

Pinsky Paul F, Kramer Barnett S, Crawford E David, Grubb Robert L, Urban Donald A, Andriole Gerald L, et al. Prostate volume and prostate-specific antigen levels in men enrolled in a large screening trial. Urology. 2006; 68: 352-6.

Taiji Tsukamoto, Naoya Masumori, Mahbubur Rahman, Martin M Crane. Change in international prostate symptom score, prostate-specific antigen and prostate volume in patients with benign prostatic hyperplasia followed longitudinally. Int J Urol. 2007; 14: 321-4.

AUA Practice Guidelines Committee. AUA guideline on management of benign prostatic hyperplasia 2003. Chapter 1: diagnosis and treatment recommendations. J Urol. 2003; 170: 530-47.

Netto NR, D’Ancona CAL, Delima ML. Correlation between international prostatic symptom score and pressure flow study in the evaluation of symptomatic BPH. J Urol. 1996; 155: 200-2.

Wadie BS, Ibrahim EH, de la Rosette JJ, Gomha MA, Ghoneim MA. The relationship of the IPSS and objective parameters for diagnosing bladder outlet obstruction. Part I: when statistics fail. J Urol. 2001; 165: 32-4.

Mochtar CA, Kiemeney LA, van Riemsdijk MM, Laguna MP, Debruyne FM, de la Rosette JJ. Post-void residual urine volume is not a good predictor of the need for invasive therapy among patients with benign prostate hyperplasia. J Urol. 2006; 175: 213-16.

Chia SJ, Heng CT, Chan SP, Foo KT. Correlation of intravesical prostatic protrusion with bladder outlet obstruction. BJU Int. 2003; 91: 371-4.

Roehrborn CG, Malice M, Cook TJ, Girman CJ. Clinical predictors of spontaneous acute urinary retention in men with LUTS and clinical BPH: a comprehensive analysis of the pooled placebo groups of several large clinical trials. Urology. 2001; 58: 210-16.

Anderson JB, Roehrborn CG, Schalken JA, Emberton M. The progression of benign prostatic hyperplasia: examining the evidence and determining the risk. Eur Urol. 2001; 39: 390-9.

Roehrborn CG, Boyle P, Bergner D. Serum prostate specific antigen and prostate volume predict long-term changes in symptoms and flow-rate: results of four-year, randomized trial comparing finasteride versus placebo. PLESS Study Group. Urology. 1999; 54: 662-9.

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.

Mochtar CA, Kiemeney LA, van Riemsdijk MM. Prostate specific antigen as an estimator of prostate volume in the management of patients with symptomatic benign prostatic hyperplasia. Eur Urol. 2003; 44: 695-700.

Roehrborn CG, McConnell JD, Lieber M. Serum prostate specific antigen concentration is a powerful predictor of acute urinary retention and need for surgery in men with clinical benign prostatic hyperplasia. PLESS Study Group. Urology. 1999; 53: 473-80.

Laniado ME, Ockrim JL, Marronaro A, Tubaro A, Carter SS. Serum PSA to predict the presence of bladder outlet obstruction in men with urinary symptoms. BJU Int. 2004; 94: 1283-6.

Tan YH, Foo KT. Intravesical prostatic protrusion predicts the outcome of a trial without catheter following acute urine retention. J Urol. 2003; 170: 2339-41.

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Department of Urology, Faculty of Medicine/Airlangga University