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The role of intravesical prostatic protrusion in the evaluation of overactive bladder in male patients with LUTS

  • Urology - Original Paper
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Abstract

Purpose

To evaluate the association of intravesical prostatic protrusion (IPP) and overactive bladder (OAB) in male patients with lower urinary tract symptoms (LUTS). IPP has been suggested to correlate with storage symptoms in addition to bladder outlet obstruction.

Methods

This was an open-labeled, single-center, prospective study involving 128 men older than 40 years presenting with LUTS. We analyzed the relationship of IPP with age, prostate volume, uroflowmetry, post-void residual urine volume (PVR), International Prostate Symptom Score (IPSS), urgency severity scale (USS), and OAB symptom score (OABSS). The patients with an urgency score of ≥ 2 (OABSS question 2) and sum score of ≥ 3 were considered to have OAB. IPP was measured in the mid-sagittal section using transrectal ultrasound. The degree of IPP was classified as grade 1 (≤ 5 mm), grade 2 (> 5–10 mm), and grade 3 (> 10 mm).

Results

The mean age of the patients was 64.9 ± 9.2 years, and 101 patients were diagnosed with OAB (79%). Mean IPPs were 2.4 ± 1.4 mm (grade 1, n = 77), 7.6 ± 1.4 mm (grade 2, n = 27), and 14.8 ± 4.4 mm (grade 3, n = 24). IPP was positively correlated with age, prostate size, PSA, PVR, and OABSS nocturia subscore, but not correlated with the presence or severity of OAB. Areas under the receiver-operating characteristic (ROC) curves for the diagnosis of OAB were 0.807 and 0.604 for IPSS-storage subscore and IPP, respectively.

Conclusion

IPP is not a good predictor of OAB in men presenting with LUTS. However, grade 3 IPP indicates higher frequency of nocturia.

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Acknowledgements

The authors would like to thank Pei-Wen Chang Chien, Hui-Hsin Huang, and Biostatistics Center of Kaohsiung Chang Gung Memorial Hospital for statistical analysis.

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Authors and Affiliations

  1. Department of Urology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 123 Ta Pei Road, Niao Song District, Kaohsiung, Taiwan

    Chia-Hung Tsai, Wei-Chia Lee, Yuan-Chi Shen, Hung-Jen Wang & Yao-Chi Chuang

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  1. Chia-Hung Tsai
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  2. Wei-Chia Lee
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  3. Yuan-Chi Shen
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  5. Yao-Chi Chuang
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Correspondence to Yao-Chi Chuang.

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Tsai, CH., Lee, WC., Shen, YC. et al. The role of intravesical prostatic protrusion in the evaluation of overactive bladder in male patients with LUTS. Int Urol Nephrol 52, 815–820 (2020). https://doi.org/10.1007/s11255-019-02370-4

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  • DOI: https://doi.org/10.1007/s11255-019-02370-4

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