Prostatic zonal parameters and lower urinary tract symptoms as quantified via magnetic resonance imaging

Authors

  • Joseph Moryousef McGill University
  • Christina Sze Department of Urology, Weil Cornell Medicine/New York Presbyterian Hospital
  • Dean S. Elterman Division of Urology, University Health Network, University of Toronto
  • Kevin C. Zorn Division of Urology, Centre Hospitalier de l’Université de Montréal
  • Naeem Bhojani Division of Urology, Centre Hospitalier de l’Université de Montréal
  • Bilal Chughtai Department of Urology, Weil Cornell Medicine/New York Presbyterian Hospital

DOI:

https://doi.org/10.5489/cuaj.8139

Keywords:

benign prostatic hyperplasia, prostatic zones, intraprostatic protrusion, lower urinary tract symptoms, quality of life

Abstract

INTRODUCTION: Benign prostatic hyperplasia (BPH) is a common diagnosis among aging males; however, the relationship between prostate volume and lower urinary tract symptom (LUTS) severity is imperfect. The goal of this study was to comprehensively investigate the relationship between various prostate zone-based parameters measured using magnetic resonance imaging (MRI) and LUTS.

METHODS: Data were retrospectively collected for 144 patients who underwent MRI between 2015 and 2017 at a single institution. Prostate volumes were measured on sagittal and axial T2 weighted using the prostate ellipsoid formula.

RESULTS: Only transition zone thickness (TZT) correlated with International Prostate Symptom Score (IPSS) (Pearson’s=0.33, p=0.007). The intraprostatic protrusion (IPP) component (rho=0.261, p=0.036), transitional zone volume (TZV) (rho=0.264, p=0.034), and TZT (Pearson’s correlation=0.422, p<0.001) all correlated with worsening quality of life (QoL) scores. In total, 97.9% of men had the presence of an IPP (>0 mm) and larger IPPs were found in older men with higher postvoid residual volumes. Larger peripheral zone volume (PZV) (odds ratio [OR] 3.62, 95% confidence interval [CI] 1.07–12.30, p<0.05), TZV (OR 6.00, 95% CI 1.69–21.35, p<0.05), and TZT (OR 4.00, 95% CI 1.17–13.69, p<0.05) were predictive of developing severe LUTS; however, IPP (p=0.122) was not.

CONCLUSIONS: TZV, TZT, and IPP all demonstrated a role in the evaluation of LUTS, with predictive capabilities. IPP is very common but not always clinically significant. Clarifying more precise zonal parameters and their relationship with LUTS may ultimately help clinicians guide the need for surgical intervention more precisely.

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Published

2023-02-02

How to Cite

Moryousef, J., Sze, C. ., Elterman, D. S., Zorn, K. C. ., Bhojani, N., & Chughtai, B. (2023). Prostatic zonal parameters and lower urinary tract symptoms as quantified via magnetic resonance imaging. Canadian Urological Association Journal, 17(5), E104–9. https://doi.org/10.5489/cuaj.8139

Issue

Section

Original Research