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

Abstract

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. This was an open-labeled, single-center, prospective study involving 128 men older than 40years 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 (≤ 5mm), grade 2 (> 5-10mm), and grade 3 (> 10mm). The mean age of the patients was 64.9 ± 9.2years, and 101 patients were diagnosed with OAB (79%). Mean IPPs were 2.4 ± 1.4mm (grade 1, n = 77), 7.6 ± 1.4mm (grade 2, n = 27), and 14.8 ± 4.4mm (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. IPP is not a good predictor of OAB in men presenting with LUTS. However, grade 3 IPP indicates higher frequency of nocturia.