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. 2010 Oct;51(10):694-9.
doi: 10.4111/kju.2010.51.10.694. Epub 2010 Oct 21.

Clinical and urodynamic significance of morphological differences in intravesical prostatic protrusion

Seung Wook Lee  1 , Jeong Man Cho, Jung Yoon Kang, Tag Keun Yoo
Affiliations

Clinical and urodynamic significance of morphological differences in intravesical prostatic protrusion

Seung Wook Lee et al. Korean J Urol. 2010 Oct.

Abstract

Purpose: The objectives of this study were to evaluate whether morphologic differences correlated with urodynamic and clinical characteristics in patients with benign prostatic hyperplasia (BPH) with intravesical prostatic protrusion (IPP) of trilobar or bilobar adenoma.

Materials and methods: Between January 2008 and June 2009, 72 male patients who had undergone transurethral resection (TUR) owing to BPH with IPP were included in this study. They underwent preoperative urodynamic studies, the International Prostate Symptom Score (IPSS)/quality of life (QoL), maximal flow rate (Qmax), post-voiding residual urine volume (PVR), transrectal ultrasonography (TRUS), and serum prostate-specific antigen (PSA) measurement. The patients were classified into 2 groups (the trilobar and bilobar adenoma groups) on the basis of video findings during the TUR operation.

Results: The trilobar and bilobar adenoma groups consisted of 37 patients and 35 patients, respectively. The Mean±SD IPP, prostate volume (PV), and transition zone volume of the trilobar and bilobar adenoma groups were 11.8±5.2 mm and 9.0±3.8 mm (p=0.014), 81.1±25.8 g and 59.3±22.5 g (p<0.001), and 49.6±20.6 g and 34.8±19.4 g (p=0.003), respectively. The Mean±SD PSA, bladder contractility index (BCI), and bladder outlet obstruction index (BOOI) were 4.6±2.5 ng/ml and 3.5±1.7 ng/ml (p=0.042), 119.8±33.4 and 87.7±24.4 (p<0.001), and 62.6±29.5 and 44.6±20.4 (p=0.005), respectively. There were no significant differences in IPSS/QoL, Qmax, PVR, acute urinary retention, or detrusor overactivity in the 2 groups.

Conclusions: IPP has two morphologic types of trilobar or bilobar enlargement. The PV, BOOI, and BCI were significantly smaller in the bilobar adenoma group than in the trilobar adenoma group.

Keywords: Prostatic hyperplasia; Ultrasonography; Urodynamics.

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Conflict of interest statement

The authors have nothing to disclose.

Figures

FIG. 1
FIG. 1
The grading system for IPP. (A) Grade I (<5 mm), (B) Grade II (5-10 mm), and (C) Grade III (>10 mm) IPP. IPP: intravesical prostatic protrusion.
FIG. 2
FIG. 2
Anatomical differences in IPP configuration between trilobar (A) and bilobar (B) adenomas. IPP: intravesical prostatic protrusion.
FIG. 3
FIG. 3
Scatter plot of the relationship between BOOI and IPP. (A) Scatter plot of the relationship between BOOI and IPP in the total patients (r=0.608, p<0.001). (B) Scatter plot of the relationship between BOOI and IPP in the trilobar adenoma group (r=0.718, p<0.001). (C) Scatter plot of the relationship between BOOI and IPP in the bilobar adenoma group (r=0.265, p=0.136). BOOI: bladder outlet obstruction index, IPP: intravesical prostatic protrusion.
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