Relationship between benign prostatic hyperplasia and lower urinary tract symptoms and correlation between prostate volume and serum prostate-specific antigen in clinical routine

Abstract

Objectives: To evaluate how often benign prostatic hyperplasia (BPH) was diagnosed in men referred as a result of lower urinary tract symptoms (LUTS) and to investigate the correlation between prostate volume and serum prostate-specific antigen (s-PSA).

Material and methods: The study subjects comprised men (n = 119; mean age 68 years) consecutively referred to a urological clinic as a result of LUTS for whom the information in the referral forms gave no indications of malignant disease or infection. The patients were evaluated according to regional guidelines.

Results: BPH was estimated to be the main etiological agent in less than every second man. There was a statistically significant correlation between s-PSA and prostate size. However, among men with s-PSA < 1.5 ng/ml, one-third had a prostate volume of > 30 ml and 17% a prostate volume of > 40 ml. Among men with s-PSA > or = 1.5 ng/ml, as many as 18% had a prostate volume of < or = 30 ml and 42% a prostate volume of < or = 40 ml. Bladder and/or prostate cancer was diagnosed in 8% of men, mostly as a coincidental finding.

Conclusions: BPH was considered to be the etiological factor in < 50% of men referred as a result of LUTS. The correlation between prostate volume and s-PSA was verified. However, interindividual variation in s-PSA was so large that its usefulness for making treatment decisions in men with LUTS must be questioned.