Intravesical Prostatic Protrusion as A Predictor of Need for Surgical Therapy in Benign Prostatic Hyperplasia Patients

Abstract

Intravesical prostatic protrusion (IPP) can predict disease progression and development of complications in benign prostatic hyperplasia (BPH). The aim was to determine if IPP at initial evaluation can predict need for surgical therapy in BPH patients. A retrospective study of BPH patients at ESUT Teaching Hospital, Enugu. Patients were involved in a previous prospective study in which they had abdominal ultrasonography measurement of IPP and prostate volume (TPV). IPP was measured in millimeter and divided into < 10 mm and ≥ 10 mm. The clinicians were blinded about the patients’ IPP while making decision for therapy. After at least a 24-month follow up period, biodata, IPP, TPV, IPSS and therapy given/recommended were retrieved and analyzed. The odds ratio of having/awaiting surgery at IPP cut-off of 10 millimeters was calculated. P < 0.05 was considered significant. One hundred patients’ records were reviewed. Forty-four patients (44%) were still on medical therapy, 20 (20%) were awaiting surgery and 36 (36%) had prostatectomy. Eight (19.05%) of 42 patients with IPP < 10 mm had or were recommended for surgical therapy while 48 (82.76%) of 58 patients with IPP ≥ 10 mm had or were recommended for surgical therapy (p=0.000). There was a statistically significant odd for surgical therapy when IPP at initial evaluation was ≥ 10mm (OR=20.40, 95% CI [7.30,57.04]). IPP at initial evaluation ≥ 10 mm is a significant predictor of needing surgical therapy in BPH patients.