Is Intravesicular Prostatic Protrusion Associated with more Complications in BPH patients? – A Preliminary Report

Abstract

Introduction: Benign prostatic hyperplasia (BPH) is a common cause of bladder outlet obstruction (BOO) in ageing men and can, with progression of the disease, lead to complications. Intravesical Prostatic Protrusion (IPP) has been shown to correlate with severity of symptoms in BPH patients. Aim: Determine relationship between IPP and complications in BPH. Methods: A cross-sectional prospective study of new symptomatic BPH patients who presented for urology services at ESUTH, Parklane-Enugu. Ethical approval and informed consent were obtained. Participants were assessed for acute urinary retention (AUR), chronic urinary retention (CUR), hernia, epididymoorchitis, fever, urinary tract infection (UTI), haematuria and serum creatinine (SCr). They had abdominal ultrasonography measurement of IPP from midline sagittal image of the prostate (at bladder volume ≥ 200mls); measurement of prostate volume (PV), anterior bladder wall thickness (BWT) and post-void urine residue (PVR); and assessment for hydronephrosis, bladder diverticulum and urolithiasis using Sonoscape S11 (Sonoscape Co Ltd, Shenzhen, China) with abdominal probe frequency of 3.5 MHz. IPP was divided into two groups (non-significant < 10mm and significant ≥ 10mm). Data was analyzed using SPSS version 21 (IBM, SPSS, Chicago, USA). The data was subjected to ANOVA and Chi square. Pearson's correlation was used to assess correlation where necessary. P-Value < 0.05 was considered significant. Results: Ninety-one men with a mean age, PV, IPP, PVR, BWT and SCr of 63.81 years, 115.92mls, 14.14mm, 184.93mls, 4.81mm and104.74 μmol/L respectively were included in the study. There was positive correlation between IPP and PVR (p= 0.000); BWT (p= 0.000); SCr (p=0.160); PV (p=0.197). There is more AUR(p=0.003), CUR(p=0.015), hydronephrosis (p=0.003) and haematuria (p= 0.032) in the group with significant IPP but no significant difference in UTI (p= 0.254), Fever (p=0.216), epididymoorchitis (p=0.313), hernia (p=0.179) and urolithiasis (p= 0.154). Conclusion: Significant IPP increases the risk of developing some complications in BPH patients.