DOI: http://dx.doi.org/10.18203/2349-2902.isj20194065

Association of metabolic syndrome with intravesical prostatic protrusion and international prostatic severity symptoms score in patients with benign prostatic enlargement

Debanga Sarma, Rajeev T. P., Ashish Ghanghoria, Saumar Jyoti Baruah, Sasanka Kumar Barua, Puskal Kumar Bagchi, Mandeep Phukan, Sarbartha Kumar Pratihar

Abstract


Background: Intravesical prostatic protrusion (IPP), a morphological change resulting from enlarged lateral and median lobe of prostate. It could be for assessment of BOO (Bladder outlet obstruction). MetS is one of the causative factors for the development of Benign Prostatic Enlargement (BPE) and associated LUTS. The aim of this study is to assess the association of components of MetS and MetS with IPP, TPV and International Prostatic Severity Symptoms Score (IPSS).

Methods: This is a single centre cross-sectional study in Department of Urology, GMCH, Guwahati, Assam, India between March 2016 and May 2018, 114 consecutive men aged >50 years presenting with LUTS suggestive of BPE (PSA 0-4ng/ml). MetS was defined according to International Diabetes Federation criteria. We have analysed IPSS and IPP of these patients. Patients were classified into 3 groups each for IPSS and IPP (IPSS: group I - 0-7, II -8-19, III ->20 and IPP: Group I- <5 mm, II- 5-10 mm, III- >10 mm).

Results: We have correlated these groups with each component of MetS and MetS. IPSS group III had significant correlation with hyperglycaemia (HG), hypertriglyceridemia (HTG), hypertension (HTN) and HDL cholesterol (HDL), group II had significant correlation with HG, HTN and HDL and group I had significant correlation with HTN (p<0.001). Similarly, IPP group III had significant correlation with HG, HTG, HTN, obesity and HDL, group II had significant correlation with HG, HTN and obesity and group I had significant correlation with HTN only (p<0.001).

Conclusions: We found that patients with higher IPSS and IPP had significant correlation with MetS components.


Keywords


Benign prostatic enlargement, Intravesical prostatic protrusion, International prostatic severity symptoms score, Metabolic syndrome, Lower urinary tract symptoms

Full Text:

PDF

References


Roehrborn CG. Benign prostatic hyperplasia:an overview. Rev Urol. 2005;7 (Suppl. 9):S3–14.

Chia SJ, Heng CT, Chan SP, Foo KT. Correlation of intravesical prostatic protrusion with bladder outlet obstruction. BJU Int. 2003;91:371–4.

Chung SD, Chiu B, Yu HJ, Keqin Z. Clinical significance of intravesical prostatic protrusion in patients with benign prostatic enlargement. Urology. 2007;70:1096–9.

Akino H, Maekawa M, Nakai M, Shioyama R, Ishida H, Oyama N, et al. Ultrasound-estimated bladder weight predicts risk of surgery for benign prostatic hyperplasia in men using alpha-adrenoceptor blocker for LUTS. Urology. 2008;72:817– 20.

Lim KB, Ho H, Foo KT, Wong MY, Fook-Chong S. Comparison of intravesical prostatic protrusion, prostate volume and serum prostatic- specific antigen in the evaluation of bladder outlet obstruction. Int J Urol. 2006;13:1509–13.

St Sauver JL, Jacobson DJ, Girman CJ, McGree ME, Lieber MM, Jacobsen SJ. Correlations between longitudinal changes in transitional zone volume and measures of benign prostatic hyperplasia in a population-based cohort. Eur Urol. 2006;50:105.

Malde S, Nambiar AK, Umbach R, Lam TB, Bach T, Bachmann A, et al. Systematic review of the performance of noninvasive tests in diagnosing bladder outlet obstruction in men with lower urinary tract symptoms. Eur Urol. 2017;71:391–402.

Alberti KG, Zimmet P, Shaw J, Group IDFETFC. The metabolic syndrome – a new worldwide definition. Lancet. 2005;366:1059–62.

Russo GI, Regis F, Spatafora P, Frizzi J, Urzì D, Cimino S, et al. Association between metabolic syndrome and intravesical prostatic protrusion in patients with benign prostatic enlargement and lower urinary tract symptoms (MIPS Study). BJU Int. 2018;121(5):799-804.

Gacci M, Corona G, Vignozzi L, Salvi M, Serni S, De Nunzio C, et al. Metabolic syndrome and benign prostatic enlargement: a systematic review and meta-analysis. BJU Int. 2015;115:24–31.

Russo GI, Castelli T, Urzi D, Privitera S, La Vignera S, Condorelli RA, et al. Emerging links between non- neurogenic lower urinary tract symptoms secondary to benign prostatic obstruction, metabolic syndrome and its components: a systematic review. Int J Urol. 2015;22:982–90.

Gacci M, Sebastianelli A, Salvi M, De Nunzio C, Vignozzi L, Corona G, et al. Benign prostatic enlargement can be influenced by metabolic profile: results of a multicenter prospective study. BMC Urol. 2017;17:22.

Lotti F, Corona G, Vignozzi L, Rossi M, Maseroli E, Cipriani S, et al. Metabolic syndrome and prostate abnormalities in male subjects of infertile couples. Asian J Androl. 2014;16:295–304.

St Sauver JL, Jacobsen SJ, Jacobson DJ, McGree ME, Girman CJ, Nehra A, et al. Statin use and decreased risk of benign prostatic enlargement and lower urinary tract symptoms. BJU Int. 2011;107:443–50

Vanella L, Russo GI, Cimino S, Fragalà E, Favilla V, Li Volti G, et al. Correlation between lipid profile and heme oxygenase system in patients with benign prostatic hyperplasia. Urology. 2014;83:1444.e7–13.

Suzuki T, Otsuka A, Ozono S. Combination of intravesical prostatic protrusion and resistive index is useful to predict bladder outlet obstruction in patients with lower urinary tract symptoms suggestive of benign prostatic hyperplasia. Int J Urol. 2016;23:929–33.

Kyung YS, You D, Jeong IG, Han S, Kim HK, Kim CS. Changes in weight and metabolic syndrome are associated with prostate growth rate over a 5-year period. Urology. 2017;103:185–90.

Russo GI, Cimino S, Castelli T, Favilla V, Gacci M, Carini M, et al. Benign prostatic hyperplasia, metabolic syndrome and non-alcoholic fatty liver disease:is metaflammation the link? Prostate. 2016;76:1528–35.