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Is periurethral calcification associated with urinary flow rate and symptom severity in men with lower urinary tract symptoms-benign prostatic hyperplasia? A retrospective review

 Jang Hee Han  ;  Jong Kyu Kwon  ;  Joo Yong Lee  ;  Dong Hyuk Kang  ;  Ho Chul Choi  ;  Jong Soo Lee  ;  Kang Su Cho 
 UROLOGY, Vol.85(5) : 1156-1161, 2015 
Journal Title
Issue Date
Aged ; Calcinosis/complications* ; Calcinosis/physiopathology* ; Humans ; Lower Urinary Tract Symptoms/complications* ; Lower Urinary Tract Symptoms/physiopathology* ; Male ; Middle Aged ; Prostatic Hyperplasia/complications* ; Prostatic Hyperplasia/physiopathology* ; Retrospective Studies ; Severity of Illness Index ; Urethra ; Urination*
OBJECTIVE: To evaluate the association of periurethral calcification (PUC) with urine flow rate and symptom severity in men with lower urinary tract symptoms-benign prostatic hyperplasia (LUTS-BPH). METHODS: The records of 1199 LUTS-BPH patients were obtained from a prospectively maintained database of men on their first visit from April 2010 to April 2013. Patients with incomplete data or comorbidities affecting voiding function were excluded. The degree of PUC was scored by evaluating the ratio of the calcified urethra to the entire prostatic urethra on the midsagittal plane of a transrectal ultrasonogram. The relationships between prostate-related parameters, International Prostate Symptom Score (IPSS), and uroflowmetric parameters were evaluated. RESULTS: A total of 1030 patients were eligible for final analysis. There were 654 patients (63.5%) with no PUC, 233 (22.6%) with mild PUC, and 143 (13.9%) with moderate to severe PUC. The total IPSS was 16.21 ± 7.29, 17.74 ± 7.77, and 17.75 ± 7.60 in no, mild, and moderate to severe PUC groups, respectively (P = .007), whereas peak urinary flow rate (Qmax) was 15.05 ± 7.59, 13.62 ± 6.68, and 12.20 ± 6.39 mL/s, respectively (P <.001). In an age-adjusted partial correlation test, PUC significantly associated with total IPSS, the storage symptom score, and Qmax (P <.05). Multivariate analysis revealed that PUC independently associated with Qmax (P = .012), total IPSS (P = .042), and the storage symptom score (P = .018) but not with postvoid residue, the voiding symptom score, or the postmicturition symptom score. CONCLUSION: PUC is independently associated with Qmax and urinary symptoms indirectly advocating for the recent idea that periurethral fibrosis and stiffness could cause LUTS-BPH in men.
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1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
7. Others (기타) > Dept. of Health Promotion (건강의학과) > 1. Journal Papers
Yonsei Authors
Kwon, Jong Kyou(권종규)
Lee, Jong Soo(이종수) ORCID logo https://orcid.org/0000-0002-9984-1138
Lee, Joo Yong(이주용) ORCID logo https://orcid.org/0000-0002-3470-1767
Cho, Kang Su(조강수) ORCID logo https://orcid.org/0000-0002-3500-8833
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