title: Clinical significance of peripheral zone thickness in men with lower urinary tract symptoms/benign prostatic hyperplasia.
abstract: OBJECTIVE
  To evaluate the clinical impact of prostate peripheral zone thickness (PZT), based on presumed circle area ratio (PCAR) theory, on urinary symptoms in men with lower urinary tract symptoms/benign prostatic hyperplasia (LUTS/BPH) as a novel prostate parameter.
  
  
  METHODS
  Medical records were obtained from a prospective database of first-visit men with LUTS/BPH. Age, international prostate symptom score (IPSS), overactive bladder symptom score (OABSS), maximum urinary flow rate (Qmax ), and post-void residual urine volume (PVR) were assessed. Total prostate volume (TPV), transition zone volume (TZV), transition zone index (TZI), and PZT were measured by transrectal ultrasonography. Reliability analysis was also performed.
  
  
  RESULTS
  In all, 1009 patients were enrolled for the analysis. The mean (sd) PZT was 11.10 (2.50) mm, and patients were classified into three groups PZT thickness groups; PZT <9.5 mm, ≥9.5 to <13 mm, and ≥13 mm. As the PZT became smaller, all urinary symptom scores including IPSS, quality of life (QoL), and OABSS significantly increased. Uroflowmetry variables, such as Qmax and PVR, also showed significant differences. PZT showed a high intra-class correlation coefficient (0.896). Multivariate analysis revealed that the PZT was independently associated with IPSS (P < 0.001), QoL (P = 0.003), OABSS (P = 0.001), and PVR (P = 0.001), but PZT influence on Qmax was only of borderline significance (P = 0.055).
  
  
  CONCLUSIONS
  PZT is a novel, easy-to-measure prostate parameter that is significantly associated with urinary symptoms. Our present findings suggest that clinical usefulness of PZT should be further validated for managing men with LUTS/BPH.
authors: Department of Urology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea.
authors: Jong Kyou
authors: JK
authors: Kwon
authors: Department of Urology, Gangnam Severance Hospital, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea.
authors: Jang Hee
authors: JH
authors: Han
authors: Department of Urology, Gangnam Severance Hospital, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea.
authors: Ho Chul
authors: HC
authors: Choi
authors: Department of Urology, Yangpyeong Health Center, Yangpyeong, Korea.
authors: Dong Hyuk
authors: DH
authors: Kang
authors: Department of Urology, Gangnam Severance Hospital, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea.
authors: Joo Yong
authors: JY
authors: Lee
authors: Department of Urology, Sooncheonhyang University Hospital, Suncheonhyang University College of Medicine, Seoul, Korea.
authors: Jae Heon
authors: JH
authors: Kim
authors: Department of Urology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea.
authors: Cheol Kyu
authors: CK
authors: Oh
authors: Department of Urology, Gangnam Severance Hospital, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea.
authors: Young Deuk
authors: YD
authors: Choi
authors: Department of Urology, Gangnam Severance Hospital, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea.
authors: Kang Su
authors: KS
authors: Cho
mesh_terms: D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000175:diagnosis / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D011237:Predictive Value of Tests; D011467:Prostate / Q000473:pathology*; D011470:Prostatic Hyperplasia / Q000175:diagnosis / Q000473:pathology*; D011788:Quality of Life; D015203:Reproducibility of Results; D053201:Urinary Bladder, Overactive / Q000175:diagnosis / Q000473:pathology*
keywords: benign prostatic hyperplasia; lower urinary tract symptoms; peripheral zone; transrectal ultrasound