Anatomic Configuration of Prostate Obtained by Noninvasive Ultrasonography Can Predict Clinical Voiding Parameters for Determining BOO in Men With LUTS

Objectives

To determine whether the anatomic configuration of the prostate, including the intravesical prostatic protrusion (IPP), as assessed by noninvasive ultrasonography, can predict the voiding parameters in men aged ≥50 years who present with lower urinary tract symptoms.

Methods

We assessed 157 consecutive men aged ≥50 years who presented with lower urinary tract symptoms at their first visit. The initial evaluations included medical history, International Prostate Symptom Score and quality-of-life assessments, digital rectal examination, urinalysis, total serum prostate-specific antigen measurement, and free uroflowmetry and postvoid residual urine volume assessments. Transabdominal ultrasonography was used to assess the IPP and prostate contour, and transrectal ultrasonography was used to obtain a classification of benign prostatic hyperplasia.

Results

A total of 9 patients, 4 (5.0%) with a type 1 and 5 (16.7%) with a type 3 prostate contour presented with acute urinary retention. All patients with acute urinary retention were classified as having IPP grade 3. The storage International Prostate Symptom Score differed significantly between patients with IPP grade 1 and those with IPP grade 2 or 3. The peak urinary flow rate was significantly reduced in patients with type 2 and 3 and those with IPP grade 3. The stratification of the patients into 3 groups according to prostate volume (<30, 30-40, and >40 cm³) showed that those with type 2 and 3 had a significantly lower peak urinary flow rate.

Conclusions

The results of our study have shown that, in addition to IPP, patients with a type 2 or 3 prostate contour are more likely to have a decreased peak urinary flow rate and to present with acute urinary retention. However, larger scale studies are needed to confirm these results.