Hypothesis / aims of study
Aim of our study was to evaluate the association between prostatic calcification, evaluated by transrectal ultrasound, and LUTS in patients with benign prostatic enlargement (BPE).
Study design, materials and methods
From 2009 onward, a consecutive series of patients with LUTS-BPE were enrolled. Patients were evaluated using the International Prostate Symptom Score (IPSS) and transrectal ultrasonographic prostate volume. Body mass index, waist circumference and blood pressure were measured. Blood samples were collected for prostate-specific antigen levels. Prostatic calcifications were evaluated by transrectal ultrasound. Number of significative calcifications was defined≥ 4. Storage (sIPSS≥ 4) and nocturia ≥ 2 were considered significant. The risk of detecting significant storage symptoms and nocturia were evaluated using the logistic regression analysis.
201 patients were enrolled in two centers (Rome, Acquaviva delle Fonti, Italy) with a median age of 68 years (IQR 64/76) and PSA of 5 ng/ml (IQR 5/7). Median waist circumference was 94 cm (IQR: 89/102) and median IPSS was 10 (IQR 5/15). Overall 71/201 (35%) presented nocturia ≥2 and 75/201 (37%) presented sIPSS≥4. Overall 90/201 (45%) presented prostatic calcification and out of them 44/90 (49%) presented at least 4 calcifications. Patients with significant prostatic calcifications (at least 4) presented a significant higher sIPSS (5, IQR 3/10 vs 4, IQR 2/6; p= 0.018) and nocturia episodes (2, IQR 2/4 vs 1, IQR 1/2 vs, p= 0.001).
Interpretation of results
On multivariate analysis, prostatic calcifications were independent risk factors for storage LUTS (OR=2.87; CI: 1,36-6.05; p=0.012) and nocturia (OR: 2.7; CI: 1.24-3.2, p=0.005).