Ultrasound derived-parameters and symptom severity scores as noninvasive predictors of bladder outlet obstruction in patients with benign prostatic enlargement

Abstract

Introduction: Benign prostatic hyperplasia (BPH) is common in men over 50 years and causes lower urinary tract (LUT) symptoms. There is an emerging need to explore the value of utilizing ultrasound (US)-derived parameters of the LUT as noninvasive predictors of the degree of bladder outlet obstruction (BOO) from BPH and determine if they correlate with the symptom severity observed in these patients. This study aimed to determine the utility of US-derived parameters of the LUT (prostate volume [PV], bladder wall thickness [BWT], and postvoid residual volume [PVR]) in predicting severity of BOO and correlating them with the symptom severity scores – International Prostate Symptom Score (IPSS) and quality of life (QoL) – in patients with BPH in our practice. Methodology: We prospectively studied 100 newly diagnosed patients with symptomatic BPH who presented to the urology outpatient clinic and were referred to the radiology department for transabdominal scan of the urinary bladder and prostate. The patients' age, IPSS, and QoL and their BWT1 (full bladder), BWT2 (empty bladder), PV, and PVR were measured using transabdominal US scan. Correlation was done using Pearson's correlation coefficient, and P < 0.05 was considered statistically significant. Results: The mean age of the participants was 60 years. The mean BTW1 and BTW2 were 4.66 mm and 25.80 mm, respectively. The mean IPSS was 16, with a majority (42%) having severe symptoms. There is a negative insignificant correlation between PVR and BTW2 (r = −0.053, P = 0.603). There is a weak but statistically insignificant correlation between QoL and BWT. There is a weak but insignificant correlation between PV and IPSS (r = 0.193, P = 0.055). There is a weak but insignificant correlation between IPSS and BWT. There is a moderate and statistically significant correlation between IPSS and PVR (r = 0.350, P < 0.001). Conclusion: In our patients, we found that BWT had an insignificant correlation with QoL and a negative correlation with PVR, respectively. We could show, however, that in them, PVR and IPSS were significantly correlated.