Category: BPH/LUTS: Outcomes & Complications

MP33-18 - Intravesical Prostatic Protrusion and Intravesical Prostatic Protrusion to Prostate Size Ratio As Predicting Factors of Rapid Clinical Progression To Surgery in Patients with Benign Prostatic Enlargement

Sun, Sep 23
2:00 PM - 4:00 PM

Introduction & Objective :

To assess intravesical prostatic protrusion (IPP) and IPP to prostate size ratio as predicting factors of time interval to surgery in patients receiving medical treatment


Methods :

980 patient records who underwent prostate surgery between January 2009 to December 2016 were evaluated retrospectively. Patients with no preoperative evaluation of intravesical prostatic protrusion and time interval to surgery under medical treatment were excluded from the trial. All patients were evaluated for age, prostate volume (PV), preoperative tPSA level(ng/dl), bladder wall thickness(mm), IPP, duration under medical treatment before surgery and IPP/PV ratio. Patients were divided into 3 groups according to IPP grade. Grade I IPP was considered as IPP less 5 mm, grade II as 5-10 mm and grade III as >10 mm protrusion. Spearman rank correlation test was utilized evaluate correlations between IPP&IPP/PV ratio and time interval to surgery. Kruskal Wallis test was utilized to compare mean values of 3 groups<./p>


Results :

276 patients meeting inclusion criteria were included to the trial. Mean age was 66,89(41-86). There was 159 patients in grade I group, 41 patients in the grade 2 group and 76 patients in grade 3 group. Baseline prostate volume was significantly increased in grade 3 IPP group.(82.97 vs grade I; 65.58, grade II; 66.96, p=0.02). Prostate size was not found correlated with time interval to surgery.(Correlation coefficient: 0.087, p=0.149) Baseline tPSA levels and age was comparable between groups. Significant positive correlation was observed between preoperative bladder wall thickness and IPP.(correlation cofficient; 0.420, p=0.002). Statistically significant moderate negative correlation was observed between IPP and time interval to surgery.(correlation cofficient; -0.474, p<0.001) IPP/Prostate size ratio is a novel paramater, described in this trial for the first time and was also found correlated with time interval under medical treatment before surgery.(correlation coefficient; -0.464, p<0.001)


Conclusions :

IPP and IPP/PV ratio are two factors predicting faster progression to surgery in patients under medical management. IPP/PV ratio is a novel parameter with promising results reported in this trial and should be evaluated in further studies.

Önder Yaman

Professor of Urology
Department of Urology, Ankara University School of Medicine, Ankara, Turkey.
Ankara, Ankara, Turkey

Onder Yaman, MD, FEBU, FECSM, Professor of Urology
o In 1989, worked as a intern for 2 months at Bangour General Hospital, Edinburgh/Scotland Deparment of Plastic Surgery, and in 1990 at St.Johannsspital, Salzburg/Austria Department of Urology / Andrology for 1 month.
o Graduated from Ankara University, Medical Faculty
o In1995 worked as "visiting physician" at Detroit Wayne State University Department of Urology, USA
o In 1996 he has finished his residency and worked as specialist of Urology; In February 2000, he has become a associate professor at Ankara University, Medical Faculty, Department of Urology.
o Between 2000-2001 he participated to "Andrology Travelling Fellowship" programme at University of Illinois, Department of Urology - Andrology in Chicago, USA
o In Juanuary 2008 he was promoted to professor of Urology at Ankara University, Medical Faculty, Department of Urology. Since than he has been working at the same position.
o Between 2002-2015 he has worked at Turkish Andrological Association Administration Committee
o Between 2009-2011 worked as the president of Turkish Andrological Association
o Between 2011-2015 worked at Turkish Urological Association Administration Committee and he worked as associated general secretary
o Between December 2015 - December 2017, worked as the president of Turkish Urological Association Administration Committee
o Since December 2017, he works as the president of Turkish Urology Board Committee.
o Between 2011-2015, he has worked as Turkish Journal of Urology Chief Editor
o 2014 he deserved the get the title "Fellow of the European Committee of Sexual Medicine: (FECSM)"
o Between 2014 - 2017 worked at European Society of Sexual Medicine administration committee
o Since 2018- he has been working as aEAU Section of Andrological Urology (ESAU) Affiliated Board Member
o He has more than 80 studies published in peer-reviewed international journals and more than 1500 citations. (h index:23 ; i10 index:44)

Barış Esen

Department of Urology, Ankara University School of Medicine, Ankara, Turkey.
Ankara, Ankara, Turkey

Muammer Babayiğit

Department of Urology, Ankara University School of Medicine, Ankara, Turkey.
Ankara, Ankara, Turkey

Khaled Obaid

Department of Urology, Ankara University School of Medicine, Ankara, Turkey.
Ankara, Ankara, Turkey

Eriz Özden

Department of Urology, Ankara University School of Medicine, Ankara, Turkey.
Ankara, Ankara, Turkey