Correlation of Detrusor Wall Thickness with International Prostate Symptom Score: A Cross-sectional Study of Nigerian Men with Prostate-Related Diseases

Abstract

Introduction: Bladder Outlet Obstruction (BOO) due to prostate- related diseases can lead to changes in bladder wall resulting in detrusor wall thickening. These changes are time-dependent and may reflect the severity of underlying BOO. Although urodynamic tests are considered to be the gold standard for the assessment of the severity of Lower Urinary Tract Symptoms (LUTS), these are time-consuming, invasive and expensive. The Detrusor Wall Thickness (DWT) measurement has emerged as a cheap, non invasive and reproducible alternative means of assessing the severity of LUTS in men with BOO. Aim: To determine the correlation between the DWT and International Prostate Symptom Score (IPSS) in men being evaluated for prostate-related BOO/LUTS. Materials and Methods: A cross-sectional hospital based study was conducted over a period of 12 months (May 2014 to April 2015), at Urology Clinics of the Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi. All 100 new consecutive male patients aged ≥40 years with prostate-related LUTS and who can achieve bladder volume of >250 mL were included in the study. The DWT was measured at three different sites (anterior, lateral and dome) at bladder volume >250 mL. Ethical approval was attained from the institutional ethical review board. Severity of LUTS was assessed using a validated IPSS questionnaire. Data was analysed using SPSS version 20. Spearman’s correlation was used to assess the correlation. The p-value <0.05 was considered significant. Results: A total of 100 men with the mean age of 71.02±9.10 years were studied. The mean duration of symptoms was 30.63±26.60 months with the average IPSS being 20.94±6.13. A total of 43 patients and 57 patients had moderate and severe LUTS, respectively. None of the patients had mild LUTS. The mean anterior, lateral, dome and average DWT measurements were 4.95±2.36 mm, 4.96±2.37 mm, 5.02±2.34 mm and 4.97±2.35 mm, respectively. A total of 97 patients had DWT ≥2 mm. There was a significant positive correlation between the DWT and IPSS (r2=0.635 and p<0.001). Conclusion: The positive correlation between the DWT and IPSS has demonstrated that the DWT measurement can be used in assessing the severity of LUTS in men with prostate-related diseases.