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CORRELATION BETWEEN INTRAVESICAL PROSTATIC PROTRUSION AND INTERNATIONAL PROSTATE SYMPTOM SCORE (IPSS) IN MEN WITH BENIGN PROSTATIC HYPERPLASIA AT NNAMDI AZIKIWE UNIVERSITY TEACHING HOSPITAL, NNEWI.

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Supervisor: PROF. ORAKWE J.C., PROF. NWOFOR A.M.E., DR. ORANUSI C.K.
Faculty: SURGERY
Month: 5
Year: 2016

Abstract

Background: Urinary problems in elderly men are often caused by prostate disorders of which BPH is the commonest. BPH presents with BOO; urodynamic study is the gold standard for diagnosis of BOO but is invasive. IPP is a non-invasive test that can predict BOO. IPSS is an objective assessment of BOO symptom severity. Objective: The objective of the study is to study the correlation between IPP and IPSS. Patients and Methods: A hospital based cross-sectional prospective study of new symptomatic BPH patients who presented to the urology clinics of Nnamdi Azikiwe University Teaching Hospital, Nnewi. Ethical approval was obtained from the ethical committee of the hospital and informed consent from patients. After evaluation (including IPSS, PSA and prostate biopsy when PSA > 4ng/ml), participants had abdominal ultrasonography measurement of IPP from midline sagittal image of the prostate (at bladder volume ≥ 100mls) using Prosound SSD3500 (Aloka Co Ltd, Tokyo, Japan) with abdominal probe frequency of 3.5 MHz. IPP was divided into three grades (grade I: 0-4.9mm; grade II:5.0-9.9 mm; grade III: 10.0 mm and above). Data was analyzed using SPSS version 20 (IBM, SPSS, Chicago, IL, USA). The data was subjected to ANOVA (to compare mean parameters among different grades of IPP) and Pearson’s correlation was used to assess correlation where necessary. P- Value < 0.05 was considered significant. Results: Hundred and one men with a mean age of 67.09±10.93 years were included in the study. The mean BMI was 25.80±3.92 kg/m2. Most of the participants had highest educational level of primary education (50.5%) while 82.2% were married. The average IPSS, IPSS-S, IPSS-V, QoL index, TPV, IPP and PSA were 17.05±7.62, 7.81±5.17, 9.24±3.16, 4.75±1.59, 68.33±46.53 mls, 13.50±7.47mm and 7.35±12.49 ng/ml respectively. There was significant differences between the mean IPSS (p = 0.000), mean IPSS-S (p = 0.000), mean IPSS-V (p = 0.002), mean TPV (p = 0.000) and mean PSA (p = 0.015) among the three grades of IPP. There were a significant positive correlations between IPP and IPSS (p = 0.000); IPSS-S (p = 0.000); IPSS-V (p = 0.000) ; IPSS QoL index (p = 0.000). Conclusion: There were significant positive correlations between IPP and IPSS, IPSS-S, IPSS-V, and IPSS QoL index. There were also significantly higher IPSS, IPSS-S, IPSS-V, and IPSS QoL index in BPH patients with IPP of 10.0 mm or more. Key Words: Intravesical prostatic protrusion, IPSS, IPSS QoL index, BPH

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