Correlation between prostate volume measured by ultrasound and symptoms severity score in patients with benign prostatic hypertrophy in Southeastern Nigeria

Abstract

Background: Benign prostatic hypertrophy (BPH) is a common urological condition in men older than 50 years. It is important in the aetiologies of life-threatening obstructive uropathies. Ultrasound measurement of prostate volume is non-invasive, easily available, and a cost-effective method, useful in assessing bladder outlet obstruction (BOO). The International Prostate Symptoms Score (IPSS) on the other hand objectively assesses symptoms severity in BOO patients.

Aim: This study was aimed at determining the correlation between ultrasound-measured prostate volume and IPSS in men with BPH.

Patients and methods: Following ethical approval from the Nnamdi Azikiwe University Teaching Hospital Ethical Committee, 100 patients who met the inclusion criteria and were diagnosed with clinical BPH were enrolled into the study. They had no other identifiable cause of BOO except BPH after clinical evaluation. The IPSS, Quality of life score (QOL), and prostate volumes were measured. Correlation between prostate volume, IPSS, and QOL were done using SPSS version 20. P value <0.05 was considered significant.

Results: The mean age of patients was 69.3 ± 10.6 years with a range of 48-100 years. The mean prostate volume, IPSS, and QOL were 96.0 ± 70.5 cm³, 15.63 ± 8.6, and 4.8 ± 1.3, respectively. The highest recorded IPSS was 35 and the lowest was 4, whereas the smallest and largest recorded prostate volumes were 19 cm³ and 350 cm³, respectively. Nocturia was the major IPSS subscore. There was a weak positive correlation between prostate volume and IPSS in men with BPH (r = +0.109; P = 0.28) and between prostate volume and QOL (r = +0.072; P = 0.45). There was also a weak positive correlation between patients with only severe symptoms and corresponding prostate volumes (r = +0.122; P = 0.125). The correlation between patients with severe symptoms and their corresponding QOL was strong (r = +0.537; P = 0.135, respectively). These findings were, however, not statistically significant.

Conclusion: There is a weak positive correlation between prostate volume measured by ultrasound and symptoms severity scores in patients with BPH, although not statistically significant. This may be as a result of the small sample size. A larger sample size may be able to achieve statistical significance.

Keywords: Benign prostatic hypertrophy; detrusor wall thickness; international prostate symptoms score; median lobe; prostate volume; quality of life.