Structural Variation of Prostate Urethra Reflected by the Ratio Between Prostate Volume and Prostatic Urethral Length is Associated with the Degrees of Lower Urinary Tract Symptoms.
OBJECTIVE
Because it is well known that the prostate volume is not directly associated with the degrees of lower urinary tract symptom (LUTS), we hypothesized that change of the prostatic urethra led by prostatic enlargement as missing links between them. To provide an integral description, we determined the ratio between prostate volume and prostatic urethral length (RPVL), and investigated its clinical implication.


METHODS
Prostate volume, prostatic urethral length, RPVL was measured from transrectal ultrasonography for 213 consecutive patients. The degree of LUTS was investigated using the international prostate symptom score (IPSS) and uroflowmetry, then the correlations were analyzed.


RESULTS
While no variables were significantly linked with total IPSS, obstructive symptoms (IPSS Q247) showed a negative association (r = -0.3, P < 0.001) and irritative symptoms (IPSS Q1356) showed a positive association solely with RPVL (r = 0.186, P = 0.007). These relevancies were enhanced (r = -0.471 [P = <0.001] and 0.3 [P = 0.004], respectively) in patients with a larger prostate (over 30 g, n = 93), but disappeared in their smaller counterparts (below 30 g, n = 120), (r = -0.133 [P = 0.143] and 0.75 [P = 0.410], respectively). In uroflowmetry, prostate urethral length showed positive correlation (r = 0.319 [P < 0.001]), and RPVL showed negative correlation (r = -0.195 [P = 0.004]) with post voiding residual amount, but these relationships similarly vanished in men with a smaller prostate.


CONCLUSIONS
The structural variation of the prostatic urethra within the prostate reflected by RPVL showed correlation with the degree of LUTS, with a tendency toward increasing prostatic urethra in obstructive and decreasing prostatic urethra in irritative symptoms, in men with a relatively large prostate.
Department of Urology, College of Medicine, Yeungnam University, Daegu, Korea.
Young Hwii
YH
Ko
Department of Urology, College of Medicine, Yeungnam University, Daegu, Korea.
Phil Hyun
PH
Song
D017677:Age Distribution; D000368:Aged; D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000097:blood / Q000209:etiology / Q000473:pathology*; D008297:Male; D009929:Organ Size; D011446:Prospective Studies; D011467:Prostate / Q000473:pathology*; D017430:Prostate-Specific Antigen / Q000378:metabolism; D011470:Prostatic Hyperplasia / Q000503:physiopathology; D014521:Urethra / Q000473:pathology*; D014563:Urodynamics / Q000502:physiology
D017430:Prostate-Specific Antigen
lower urinary tract symptoms; prostate; ultrasonography; urethra