Ultrasonographic Intravesical Prostatic Protrusion in Men with Benign Prostatic Hyperplasia in Southwest Nigeria

Abstract

Objectives: To study the relationship between sonographically measured intravesical prostate protrusion and international prostate symptoms score (IPSS), as well as prostate volume, in men with benign prostatic hyperplasia at a single health facility. Materials and Methods: This was a cross-sectional observational study of one hundred men (age >40 years) diagnosed with benign prostatic hyperplasia. Their International Prostate Symptoms Score (IPSS) was assessed using the standardised IPSS instrument. Abdominal ultrasound was done to measure the intravesical prostatic protrusion (IPP), while prostate volume was estimated transabdominally and transrectally. Correlations between parameters were quantified with Spearman’s correlation test. P ≤ 0.05 was statistically significant. Results: The mean age was 62.84 ± 9.0 years (Range =42–79 years). The mean IPSS was 20.99 ± 6.42 (range of 5–30). Seventy-three percent of the men in this study had intravesical prostatic protrusion on ultrasound. The mean IPP was 13.0 ± 4.0 mm. Of the 73 men with IPP, 17 (23.3%), 29 (39.7%), and 27 (37%) had grade I, grade II and grade III IPP, respectively. The mean transabdominal prostate volume (TPVA) and transrectal prostate volume (TPVT) were 71 ± 14 ml and 69 ± 13 ml, respectively. IPP had a statistically significant positive correlation with all the other parameters. The strongest correlation (very high correlation) was with the TPVA (r=0.797, P < 0.0001), followed by a moderate correlation with the IPSS (r =0.513, P < 0.0001). TPVT, transition zone volume, transition zone index, presumed circle area ratio, and quality of life score yielded slightly weaker moderate correlation with IPP, while IPP correlated weakly with age. Conclusion: IPP correlated well with multiple clinical and sonographic parameters. It correlated better with TPVA than TPVT.