Comparison of Lower Urinary Tract Symptoms and Urodynamic Study in BPH Patients with or without Prostatitis

Kim, Kang Won; Kwon, Dong Deuk; Park, Yang Il

Abstract

PURPOSE: Benign prostatic hyperplasia (BPH) and prostatitis may present similar clinical manifestations, although the severity of their symptoms is different. The differences between BPH patients with prostatitis and those without prostatitis were evaluated to help select appropriate therapeutic modalities and predict the prognosis.
MATERIALS AND METHODS
50 patients with BPH who were not associated with a neurogenic bladder, urethral stricture, diabetes, urinary tract infection or a previous prostate operation were studied. Of the 50 patients, 27 patients were free of prostatitis, and 23 patients had prostatitis. The mean ages of the two groups were 65.9+/-7.3 and 60+/-8.3 years, respectively. The evaluation was performed using the International Prostate Symptom Score (IPSS), uroflowmetry, the residual urine volume and urodynamic studies. Statistical analysis was performed using the Mann-Whitney test and the chi-square scales.
RESULTS
According to the IPSS, the straining score was 4.3+/-1.0/3.2+/-1.8 (p<0.05) and the urgency score was 2.4+/- 1.9/3.8+/-1.1 (p<0.05) in BPH patients without or with prostatitis. In the L-PURR, grade 3 and higher, which indicated moderate to severe obstruction, was found in 10 patients with BPH alone (37.1%) and 6 patients with BPH associated with prostatitis (26.1%) (p<0.05). Detrusor instability was identified in 22% (6/27) of patients with BPH alone and 56.5% (13/23) of those with prostatitis (p<0.05).
CONCLUSIONS
BPH patients associated with prostatitis had considerably more irritative symptoms, non-obstructive patterns and detrusor instability than those without prostatitis. These findings suggest that the relief of an obstruction by means of surgery alone should be reconsidered when treating BPH with prostatitis.