Evaluation of different MRI parameters in benign prostatic hyperplasia-induced bladder outlet obstruction

Abstract

Abstract Background Benign prostatic hyperplasia (BPH) is a common health problem faced by aging men and can be associated with bladder outlet obstruction (BOO). BPH patients usually suffer from lower urinary tract symptoms (LUTS) including obstructive and irritative urinary symptoms. The purpose of the current study was to clarify the correlation between MRI-derived prostate measurements and BPH-induced symptoms and findings including International Prostate Symptom Score (IPSS), uroflowmetry, and Postvoid residual urine (PVR). Methods In all, 34 patients (mean age was 58 ± 8 years, range 43 to 73 years) were examined by prostate MRI, uroflowmetry, postvoid residual urine, and fulfilled International Prostate Symptom Score questionnaire in this prospective study. The MRI-derived measurements including total prostate volume, transition zone volume, transition zone index, prostatic urethral angle, intravesical prostatic protrusion, and anterior fibromuscular stroma distance were correlated with International Prostate Symptom Score, uroflowmetry including maximum flow rate (Q max) and Q max grades, and postvoid residual urine using Pearson correlation coefficients (r) and multiple linear regression. Relationship between BPH types was correlated with the same parameters using one-way analysis of variance. Results We found a strong significant correlation between total prostate volume, transition zone volume, and transition zone index with International Prostate Symptom Score, Q max, Q max grades, and postvoid residual urine; however, in multiple linear regression analysis, all of them were found to be significant parameters for International Prostate Symptom Score. Also, our study showed a strong significant correlation between anterior fibromuscular stroma distance and intravesical prostatic protrusion with International Prostate Symptom Score and postvoid residual urine; however, in multiple linear regression analysis, only intravesical prostatic protrusion was found to be a significant parameter for postvoid residual urine. Our results also revealed a significant correlation between BPH types with Q max, Q max grades, International Prostate Symptom Score, and postvoid residual urine. Conclusion Several MRI-derived prostate parameters (total prostatic volume, transition zone volume, transition zone index, prostatic urethral angle, intravesical prostatic protrusion, anterior fibromuscular stroma distance, and BPH types) correlating significantly with the International Prostate Symptom Score, uroflowmetry parameters (Q max and Q max grades), and postvoid residual urine.

Keywords

• Benign prostatic hyperplasia
• MRI
• International Prostate Symptom Score
• Uroflowmetry
• Postvoid residual urine