TY - JOUR
T1 - Prostatic urethral length as a predictive factor for surgical treatment of benign prostatic hyperplasia
T2 - a prospective, multiinstitutional study
AU - Kim, Bum Soo
AU - Ko, Young Hwii
AU - Song, Phil Hyun
AU - Kim, Tae Hwan
AU - Kim, Ki Ho
AU - Kim, Byung Hoon
N1 - Publisher Copyright:
© 2019
PY - 2019/3
Y1 - 2019/3
N2 - Background: We hypothesized that prostatic anatomical factors may affect the progression of benign prostatic hyperplasia (BPH) and analyzed whether prostatic anatomical factors could be predictive of the risk of surgery. Materials and methods: From February to October 2014, 679 men older than 40 years who had lower urinary tract symptoms and enlarged prostates were enrolled from five medical centers. Patients' medical characteristics, serum prostate-specific antigen levels, transrectal ultrasound (TRUS) results, and uroflowmetry were analyzed. Using TRUS in all patients, the total prostate volume, transitional zone volume, prostatic urethral length, transitional zone urethral length, intravesical prostatic protrusion, and prostatic urethral angle were measured. Logistic regression analysis was used to determine factors associated with the risk of surgery. Receiver operating characteristic curves were used to determine cutoff values for significant variables. Results: Of 679 patients, 37 (5.4%) underwent BPH-related surgery. Prostatic urethral length and transitional zone urethral length were independently associated with the risk of surgery. Age, serum prostate-specific antigen levels, peak flow rate, postvoid residual urine, and other anatomical factors determined by TRUS were not statistically significant with respect to the risk of surgery. Using receiver operating characteristic curve–based predictions, the best cutoff values for prostatic and transitional zone urethral length were 4.53 cm (sensitivity: 83.3%, specificity: 61.6%) and 3.35 cm (sensitivity: 83.3%, specificity: 77.9%), respectively. Conclusions: This study showed that patients with BPH with longer prostatic and transitional zone urethral lengths had a higher risk of surgery. Prostatic and transitional zone urethral length may be useful predictive factors for medical treatment failure in patients with BPH.
AB - Background: We hypothesized that prostatic anatomical factors may affect the progression of benign prostatic hyperplasia (BPH) and analyzed whether prostatic anatomical factors could be predictive of the risk of surgery. Materials and methods: From February to October 2014, 679 men older than 40 years who had lower urinary tract symptoms and enlarged prostates were enrolled from five medical centers. Patients' medical characteristics, serum prostate-specific antigen levels, transrectal ultrasound (TRUS) results, and uroflowmetry were analyzed. Using TRUS in all patients, the total prostate volume, transitional zone volume, prostatic urethral length, transitional zone urethral length, intravesical prostatic protrusion, and prostatic urethral angle were measured. Logistic regression analysis was used to determine factors associated with the risk of surgery. Receiver operating characteristic curves were used to determine cutoff values for significant variables. Results: Of 679 patients, 37 (5.4%) underwent BPH-related surgery. Prostatic urethral length and transitional zone urethral length were independently associated with the risk of surgery. Age, serum prostate-specific antigen levels, peak flow rate, postvoid residual urine, and other anatomical factors determined by TRUS were not statistically significant with respect to the risk of surgery. Using receiver operating characteristic curve–based predictions, the best cutoff values for prostatic and transitional zone urethral length were 4.53 cm (sensitivity: 83.3%, specificity: 61.6%) and 3.35 cm (sensitivity: 83.3%, specificity: 77.9%), respectively. Conclusions: This study showed that patients with BPH with longer prostatic and transitional zone urethral lengths had a higher risk of surgery. Prostatic and transitional zone urethral length may be useful predictive factors for medical treatment failure in patients with BPH.
KW - Benign prostatic hyperplasia
KW - Risk factors
KW - Treatment failure
KW - Ultrasonography
UR - http://www.scopus.com/inward/record.url?scp=85049447826&partnerID=8YFLogxK
U2 - 10.1016/j.prnil.2018.06.002
DO - 10.1016/j.prnil.2018.06.002
M3 - Article
AN - SCOPUS:85049447826
SN - 2287-8882
VL - 7
SP - 30
EP - 34
JO - Prostate International
JF - Prostate International
IS - 1
ER -