Young Hwii Ko1, Tae-Hwan Kim2, Phil Hyun Song1, Byung Hoon Kim3, Bum Soo Kim2, Ki Ho Kim4, Jaeho Cho5. 1. Department of Urology, Yeungnam University College of Medicine, Daegu, Republic of Korea. 2. Department of Urology, Kyungpook National University School of Medicine, Daegu, Republic of Korea. 3. Department of Urology, Keimyung University School of Medicine, Daegu, Republic of Korea. 4. Department of Urology, Dongguk University School of Medicine, Gyeongju, Republic of Korea. Electronic address: honda400uro@gmail.com. 5. Department of Radiology, Yeungnam University College of Medicine, Daegu, Republic of Korea.
Abstract
OBJECTIVE: To describe distinctive morphologic variations of the prostate associated with the prostatic urethra, and to determine whether structural changes of the urethra within the prostate resulting from gland enlargement, rather than prostrate volume itself, lead to male lower urinary tract symptom (LUTS). MATERIALS AND METHODS: After standardizing measurements, 7 ultrasonography-determined variables, that is, prostate volume, transitional zone volume, transitional zone-to-total volume ratio, presence of intraprostatic protrusion, prostatic urethral angle, prostatic urethral length (PUL), and PUL-to-volume ratio (rPUL), were obtained prospectively in 293 men who had not taken LUTS medication during the 3 months prior to initial visits. Correlations between these variables and international prostate symptom scores (IPSS) were then investigated. RESULTS: By simple correlation, only rPUL showed a significant association with IPSS. Multiple linear regression revealed IPSS were significantly correlated with age (beta = .179, P = .04) and rPUL (beta = .139, P = .019). Subanalysis with respect to the symptoms of IPSS revealed only rPUL was correlated with voiding symptoms (Q1,3,5,6; beta = .122, P = .036), and that age alone was correlated with storage symptoms (Q2,4,7; beta = .262, P < .001). When dividing 4 groups by applying mean cut-offs for PUL (62 mm) and prostate volume (30 g), long PUL with small volume had significantly higher IPSS score than short PUL with large volume (P = .042). CONCLUSION: Structural differences of prostate related to prostatic urethra as reflected by rPUL were found to be significantly correlated with the severity of voiding symptoms. This finding suggests structural change of the prostatic urethra inducted by prostate enlargement underlies the development of male LUTS.
OBJECTIVE: To describe distinctive morphologic variations of the prostate associated with the prostatic urethra, and to determine whether structural changes of the urethra within the prostate resulting from gland enlargement, rather than prostrate volume itself, lead to male lower urinary tract symptom (LUTS). MATERIALS AND METHODS: After standardizing measurements, 7 ultrasonography-determined variables, that is, prostate volume, transitional zone volume, transitional zone-to-total volume ratio, presence of intraprostatic protrusion, prostatic urethral angle, prostatic urethral length (PUL), and PUL-to-volume ratio (rPUL), were obtained prospectively in 293 men who had not taken LUTS medication during the 3 months prior to initial visits. Correlations between these variables and international prostate symptom scores (IPSS) were then investigated. RESULTS: By simple correlation, only rPUL showed a significant association with IPSS. Multiple linear regression revealed IPSS were significantly correlated with age (beta = .179, P = .04) and rPUL (beta = .139, P = .019). Subanalysis with respect to the symptoms of IPSS revealed only rPUL was correlated with voiding symptoms (Q1,3,5,6; beta = .122, P = .036), and that age alone was correlated with storage symptoms (Q2,4,7; beta = .262, P < .001). When dividing 4 groups by applying mean cut-offs for PUL (62 mm) and prostate volume (30 g), long PUL with small volume had significantly higher IPSS score than short PUL with large volume (P = .042). CONCLUSION: Structural differences of prostate related to prostatic urethra as reflected by rPUL were found to be significantly correlated with the severity of voiding symptoms. This finding suggests structural change of the prostatic urethra inducted by prostate enlargement underlies the development of male LUTS.
Authors: Chi-Hang Yee; Sui-Fan Tang; Steffi Kar-Kei Yuen; Chi-Kwok Chan; Jeremy Y C Teoh; Peter K F Chiu; Chi-Fai Ng Journal: Int Urol Nephrol Date: 2022-05-27 Impact factor: 2.266