The correlation between obesity and prostate volume in patients with benign prostatic hyperplasia: A prospective cohort study.

OBJECTIVE/BACKGROUND: Benign prostatic hyperplasia (BPH) is increasing substantial burden on health care systems. Men with high body mass index (BMI) have bigger prostate volumes (PV) with subsequent increase in lower urinary tract symptoms (LUTS) than men with normal BMI. The purpose of this research was to investigate the correlation between Obesity and PV in patients with BPH. METHOD: The study included 560 patients (50-80 years) with BPH. Weight and height measured to calculate BMI. TRUS was used to measure PV. Patient demographics such as IPSS score and prostate specific antigen (PSA) were also noted. RESULTS: Patients in the study had a mean age of 65.3 ± 9.45 years and the mean BMI was 23.97 ± 4.89 kg/m2. The mean PV of each BMI group were 37.45 ± 0.81, 57.89 ± 1.52 and 77.94 ± 2.17 (ml) for normal, overweight and obese groups, respectively, and the average PV score was 57.76 ± 1.50 ml. The mean PSA score was 3.26 ± 0.94 (ng/dl) with a range of 0.6-10.4. There was significant correlation between BMI and PV (p = 0.001) as well as between BMI with PSA and IPSS (p = 0.02, 0.001, respectively). CONCLUSION: The results showing strong correlation between BMI and PV also BMI with PSA and IPSS. Therefore reducing weight may lead to a lower prostate volume in the elderly stage, making LUTS less noticeable and improving quality of life.

Comparison of serum uric acid levels between localised prostate cancer patients and a control group.

AIM: The aim of this study is to find out whether serum uric acid levels in patients with localised prostate cancer differ from patients with lower urinary tract symptoms without carcinoma prostate. MATERIAL AND METHODS: We performed a prospective observational study of 60 patients having age ⩾ 50 years with c/o lower urinary tract symptoms( LUTS) evaluated by digital rectal examination (DRE), prostate-specific antigen (PSA) level and ultrasonography kidney, ureter, bladder (USG KUB) prostate and patients who were suspicious for carcinoma prostate underwent trans rectal ultrasonography (TRUS) biopsy of prostate. Patients with biopsy s/o prostate cancer were evaluated for metastasis and localised cancer patients were considered as CASE group. Patients with negative biopsy and other patients having LUTS were considered as CONTROL group. The age, serum uric acid level, PSA value, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and white blood cell (WBC) count were measured. Serum uric acid level was compared in both the groups. RESULTS: The mean serum uric acid level was lower in prostate cancer group (4.77 mg/dl) than control group (6.22 mg/dl) that was statistically significant (p < 0.001). The mean PSA value was 7.43 ng/dl in cancer group and 2.72 ng/dl in control group. (p < 0.001). The mean C-reactive protein (CRP) values were 1.32 and 0.45 respectively (p < 0.001), erythrocyte sedimentation rate (ESR) were found 21 and 10.5 respectively (p < 0.001)and total leucocyte counts (TLC) were found 6.450 and 5.120 respectively (p < 0.001). All were statistically significant (p < 0.05). CONCLUSION: The serum uric acid levels measured in localised prostate cancer patients were found to be reduced compared to the control group and inflammatory markers were found to be increased. Decreased levels of serum uric acid and increased levels of inflammatory markers were determined as risk factors for prostate cancer.

Immediate effect of alpha-blockers in predicting LUTS improvement in BPH patients.

INTRODUCTION: Indications for treating Benign Prostatic Hyperplasia include reversing signs and symptoms or preventing the progression of the disease. Alpha-blockers are the most effective, least costly, and best tolerated of the drugs for relieving LUTS. The aim of the study is to investigate the immediate impact of alpha-blocker medications on lower urinary tract symptoms (LUTS). MATERIALS AND METHODOLOGY: About 100 patients were included in the study-50 patients in each of the groups A (tamsulosin) and B (silodosin). The first visit was the baseline examination before starting alpha-blockers and included history, DRE, UFM, USG KUBP with PVR, IPSS, serum PSA, serum creatinine, urine analysis, urine culture, and sensitivity. All above parameters were also at 1 week, 1 month, and 3 months following starting of alpha-blockers respectively, and compared with baseline. RESULT: As of the first, second, third, and fourth visits, the mean Qmax in group A was 10.3 ± 3.3 s, 15.08 ± 2.80 s, 15.66 ± 3.18 s, and 15.12 ± 3.24 s, respectively, while in group B it was 10.1 ± 3.1 s, 14.88 ± 2.80 s, 15.18 ± 3.18 s, and 15.08 ± 3.24 s, respectively (p < 0.001). The mean voiding time was 40.87 ± 23.91 s, 36.41 ± 20.73 s, 34.85 ± 21.37 s, and 32.07 ± 21.81 s, respectively in group A, and 41.27 ± 15.49 s, 37.23 ± 21.34 s, 38.59 ± 20.83 s, and 33.10 ±22.08. In group A, the mean PVR and IPSS scores were improved and also improved in group B. CONCLUSION: The first dose of tamsulosin and silodosin improves UFM and predicts the mid-term change in UFM as well as IPSS indices in the treatment of BPH-related LUTS.

Prevalence of LUTS in young female population attending tertiary care centre.

OBJECTIVE: To obtain the prevalence of lower urinary tract symptoms (LUTS) in young female population in tertiary care centre. METHOD: We conducted a descriptive and analytic study with ques tionnaire based data collection. All subjects were interviewed using conventional method and International Consultation on Incontinence Questionnaire (ICIQ) Female LUTS form in the urology outpatient department, SMS medical college and hospital, Jaipur (India). RESULT: Total 1278 patients enrolled in study. Using the well-structured questionnaire using ICIQ-FLUTS form, the prevalence of LUTS was 78.01% while conventional method having only 35.8%. This result revealed that LUTS is a common condition among young Indian female population with vaginal delivery as the common risk factor. CONCLUSION: Screening for LUTS using a structured questionnaire identified a significantly higher prevalence of LUTS than the conventional method. The ICIQ-FLUTS form is a robust questionnaire that can be recommended for use in epidemiological research as well as routine clinical practice.