Int Neurourol J.  2017 Sep;21(3):220-228. 10.5213/inj.1732732.366.

Clinical Significance of Periurethral Calcification According to the Location in Men With Lower Urinary Tract Symptoms and a Small Prostate Volume

• Han JH
• Lee JY
• Kwon JK
• Lee JS
• Cho KS

• KMID: 2396158
• DOI: http://doi.org/10.5213/inj.1732732.366

Abstract

PURPOSE
To assess the impact of periurethral calcification (PUC) according to its location on uroflowmetric parameters and urinary symptoms in patients with small prostate volume (PV).
METHODS
Records were obtained from a prospectively maintained database of first-visit men with lower urinary tract symptoms (LUTS). Patients whose PV was >30 mL were excluded to elucidate more clearly the impact of PUC on LUTS. A total of 539 patients were enrolled in the study. The prostatic urethra was examined by transrectal ultrasonography for PUC, and the location of PUC was divided into 3 areas (proximal, mid, and distal).
RESULTS
The characteristics according to the location of PUC were compared using a 1-way analysis of variance test. The Total International Prostate Symptom Score (IPSS), postmicturition symptoms, and overactive bladder symptom score (OABSS) differed significantly among the groups. In the propensity score matching analysis, the proximal- and distal-PUC groups did not have a significantly different urinary flow rate or symptom score when compared to their matched control groups. However, the mid-PUC group had significantly worse urinary symptoms than its matched control group (total IPSS [P=0.001], voiding symptoms [P=0.002], storage symptoms [P=0.041], and OABSS [P=0.015]). The peak urinary flow rate was also lower in the mid-PUC group with borderline significance (P=0.082). On multivariate linear regression analysis, mid-PUC was independently associated with IPSS and OABSS (P=0.035 and P=0.011, respectively).
CONCLUSIONS
Only mid-PUC was associated with symptom severity in men with LUTS and a small PV. Our findings suggest that mid-PUC could be a potential causal factor of LUTS, and the midportion of the prostatic urethra might play a pivotal role in the process of micturition.

Keyword

Urethra; Prostatic hyperplasia; Lower urinary tract symptoms; Calculi; Inflammation

MeSH Terms

Calculi
Humans
Inflammation
Linear Models
Lower Urinary Tract Symptoms*
Male
Propensity Score
Prospective Studies
Prostate*
Prostatic Hyperplasia
Ultrasonography
Urethra
Urinary Bladder, Overactive
Urination