Influence Of Anterior Lobe Thickness Of Prostate On The Clinical Progression Of Benign Prostatic Hyperplasia

PurposeInvestigate the correlation between anterior lobe thickness of prostate(ALTP)and bladder outlet obstruction(BOO),Evaluate the effect of ALTP on the clinical progress of benign prostatic hyperplasia(BPH),Study the clinical significance of appropriate preservation of the ALTP in urinary control and protection during surgery for BPH.MethodsA total of 159 patients with BPH were included in this study.Clinical indicators including ALTP,prostate volume(PV),intravesical protrusion of the prostate(IPP),residual urine(RU),maximum flow rate(Qmax),bladder outlet obstruction index(BOOI),international prostate symptom score(IPSS),body mass index(BMI),prostate-specific antigen(PSA),blood glucose and blood lipid were collected.Analyzed the correlations between ALTP and IPSS score,PV,Qmax,age and RU.Evaluated The correlation between ALTP and BOO,the ROC curve was drawn,and the cut-off point of ALTP was established,and the cut-off point was used to divide the ALTP into large and small anterior lobe of prostate groups.The differences of clinical indicators between the two groups were compared to evaluate the correlation between ALTP and clinical progress of BPH.Result(1)There was no significant correlation between ALTP and the severity of lower urinary tract symptoms(LUTS)(P >0.05);(2)There was no significant correlation between ALTP and PV,Qmax,RU and age(P >0.05);(3)The area under the ROC curve was 0.742(95% confidence interval 0.656～0.828)and the cut-off point was 0.65 cm.PV,Qmax,RU,age,IPSS and surgical rate in the large anterior lobe of prostate group(P≥0.65cm)were significantly different from those in the small anterior lobe of prostate group(P <0.05);(4)ALTP had statistical significance with risk factors as PV,IPP,PSA(P <0.05),but had no statistical significance with risk factors as age,RU(P >0.05);(5)There was no statistically significant correlation between ALTP and metabolic indexes as BMI,total cholesterol,triglyceride,high-density lipoprotein,blood glucose(P >0.05).Conclusion(1)ALTP has different thinness,which is not proportional to PV;the severity of the LUTS is not proportional to ALTP.(2)ALTP ≥ 0.65 cm increased the incidence of BOO.We proposed for the first time that ALTP≥0.65 cm may be a risk factor for clinical progression of BPH.(3)ALTP is related to risk factors as PV,IPP,PSA for clinical progression of BPH.Combining ALTP with the above risk factors to form a risk prediction model is conducive to more accurate evaluation of clinical progression of BPH.(4)With ALTP 0.65 cm as the boundary,intraoperative ALTP measured by preoperative transrectal ultrasound can be properly preserved,which can not only relieve BOO,but also protect urinary control to the greatest extent.