Correlation Of Prostate Anatomical Parameters With Urinary Symptoms And Effect Of Transurethral Resection Of Prostate In Benign Prostatic Hyperplasia

Objective: The purpose of this study was to explore the clinical value of peripheral/transition zone thickness index(PTI)in evaluating symptoms of benign prostatic hyperplasia(BPH)and predicting the effect of transurethral resection of the prostate(TURP),through comparing the correlation between the prostate anatomical parameters and the international prostate symptom score(IPSS)and maximum urine flow rate(Qmax),and the effect of prostate anatomical parameters on TURP.Methods:1.The patients with BPH were treated in Guizhou provincial People's Hospital from November 2015 to October 2018.Clinical data were recorded and analyzed.Prostate anatomical parameters were measured by transrectal ultrasound,including total prostate volume(TPV),transitional zone volume(TZV),transitional zone index(TZI),peripheral zone thickness(PZT),transitional zone thickness(TZT)and PTI(PTI = PZT / TZT).The total IPSS(IPSS-T),voiding IPSS(IPSS-V),storage IPSS(IPSS-S),post-micturitional IPPS(IPSS-P)and quality of life score(QoL)were evaluated and calculated.Qmax,and post void residual urine volume(PVR)were measured by Urodynamic tests.Pearson's correlation analysis was used to describe correlation of the prostatic anatomical parameters with IPSS(including IPSS-T,IPSS-S,IPSS-V,IPSS-P),QoL,Qmax and PVR.2.All eligible patients who received TURP were enrolled in the study.And the difference value was calculated between preoperative and 6 months postoperative(including IPSS-T,IPSS-V,IPSS-S,IPSS-P,QoL,Qmax,PVR).Prostate anatomical parameters were used to rank the patients in ascending order,and the patients were divided into three groups according to the above parameters: ?25%,> 25% and ?75%,>75%.Finally,analysis of variance was used to analyze whether there was statistical differences in difference values of IPSS?QoL?Qmax?PVR before and after operation among the three groups with different parameters.Results: 1.Pearson's correlation analysis showed that TPV(r=0.160,P<0.001)?TZV(r=0.104,P=0.016)increased with age,and TZT(r=0.118,P=0.007)was positively correlated with age,PTI(r=-0.089,P=0.039)was negatively correlated with age,but TZI and PZT were not significantly correlated with age.There was no correlation between TPV,TZV,TZI,TZT and IPSS,QoL.There was a negative correlation between PZT and IPSS-T(r=-0.126,P=0.012).PTI was negatively correlated with IPSS-T(r=-0.113,P=0.024),IPSS-S(r=-0.103,P=0.041)and IPSS-V(r=-0.123,P=0.014),but had no significant correlation with other indicators(P > 0.05).Qmax was negatively correlated with TZI(r=-0.119,P=0.042)and TZT(r=-0.118,P=0.045),and was positively correlated with PTI(r=0.157,P=0.007),and Qmax had no significant correlation with TPV,TZV and PZT(P>0.05).PVR,however,was demonstrated not correlated with all the prostatic anatomical variables(P>0.05).2.Analysis of variance showed that there was no significant difference in IPSS,QoL,Qmax and PVR between different TPV groups(P > 0.05).The results of TZV,TZT and TPV are similar.There were significant differences in IPSS-T(P=0.009),IPSS-S(P=0.010),IPSS-V(P=0.017),IPSS-P(P=0.048),QOL(P=0.005)and Qmax(P=0.005)between different PZT groups before and after operation.The difference of IPSS-T(P=0.022),IPSS-V(P=0.022)and Qmax(P=0.034)before and after operation between different TZI groups were statistically significant,but the change of IPSS-S,IPSS-P,QOL and PVR among the three groups were not statistically significant(P>0.05).The difference of IPSS-T(P=0.013),IPSS-V(P=0.031),IPSS-P(P = 0.009),QOL(P=0.013)and Qmax(P=0.006)before and after operation in different PTI groups were statistically significant,but the change of IPSS-S and PVR among the three groups were not statistically significant(P > 0.05).Conclusion:1.The concept of PTI is first proposed in this study,PTI is calculated by the prostate anatomical parameters PZT and TZT measured by ultrasound(PTI = PZT / TZT).2.TZI,PZT,TZT and PTI are correlated to symptoms of BPH patients,and PTI may be more correlated to the severity of symptoms,which is a negative correlation.3.TZT,PZT,TZI may be able to better predict the effect of TURP compared with TPV,TZV and TZT.