Correlation between Uroflowmetry and International Prostate Symptoms Score in the evaluation of Nigerian men with Benign Prostatic Enlargement.

Abstract

Background: Benign prostatic enlargement (BPE) may obstruct the urethra, reduce urine flow, and cause Lower Urinary Tract Symptoms (LUTS). Patients with LUTS can be evaluated with the International Prostate Symptom Score (IPSS) and uroflowmetry for diagnosis, treatment selection, and monitoring. There are challenges, especially in developing countries with these two investigative modalities. A level of education is needed to fill the IPSS form while most centres do not have a uroflowmeter. Studies to evaluate the relationship and compare the beneficial value of IPSS and uroflowmetry are few. This study aims to assess the correlation between IPSS and uroflowmetry in adult patients who present with LUTS secondary to BPE and compare their beneficial values. 

Methodology: The study was a hospital-based, descriptive prospective cross-sectional study of patients with LUTS secondary to BPE. Ethical committee approval and informed consent were obtained.  Every patient had the study questionnaire and IPSS questionnaire completed. Each patient also had uroflowmetry performed.  The researcher filled out the study questionnaire. Data were coded and entered using Microsoft Excel version 2010 and transferred into Statistical Package for Social Sciences Version 20 for analysis.

Results: Two hundred eighty-six patients were evaluated, but 100 met the inclusion criteria and were included in the study. The ages ranged from 48 to 93years with a mean age of 64.71± 9years. The 60 to 69 years age group had the highest frequency, 43(43%). The mean Total Prostate Volume (TPV) was 83±32.28ml. Most patients (65 patients) presented with severe LUTS (p=0.001). There was a statistically significant inverse relation between IPSS and Maximum Flow Rate (p=0.001; r= -0.624) and Average Flow Rate (p= 0,001; r= -0.578), indicating that the higher the degree of bother, the lower the Mean and Average Flow Rates. This suggests that the more the degree of bother from BPE as assessed by IPSS, the lower the urine flow rates on uroflowmetry.

Conclusion: There was a strong negative correlation between IPSS and MFR a moderate negative correlation between IPSS and AFR, showing that the higher the IPSS, the poorer the urine flow.  IPSS can be used instead of the uroflowmetry to evaluate patients with BPE if a uroflowmeter is unavailable.