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Current Bladder Dysfunction Reports

Erschienen in:

25.03.2017 | BPH-Related Voiding Dysfunction (R Lee, Section Editor)

Accurate Estimation of Prostate Size in the Evaluation of Nocturia

verfasst von: Benjamin V. Stone, Jonathan Shoag, Christopher E. Barbieri, Jim C. Hu, Richard K. Lee

Erschienen in: Current Bladder Dysfunction Reports | Ausgabe 2/2017

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Abstract

Purpose of Review

The clinical utility of the digital rectal exam (DRE) in the workup of lower urinary tract symptoms has been questioned in the literature. This review aims to critically examine the recent literature regarding the accuracy and reliability of the DRE in the assessment of lower urinary tract symptoms (LUTS) and benign prostatic hypertrophy (BPH). Here, we specifically focus on the clinical importance of the DRE in the evaluation of nocturia.

Recent Findings

Estimates of prostate size on DRE have high interexaminer variability and poor correlations with transrectal ultrasound (TRUS) volume. Prostate size estimates correlate poorly with LUTS and nocturia, while cardiovascular comorbidities are strongly associated with nocturia.

Summary

The DRE is a highly variable and inaccurate method of predicting prostate size, with limited ability to assess LUTS. Nocturia is a multifactorial condition that is often associated with medical comorbidities, and estimates of prostate size are highly unlikely to have clinical utility in the workup of this condition.

Weiss JP, Blaivas JG, Bliwise DL, Dmochowski RR, Dubeau CE, Lowe FC, et al. The evaluation and treatment of nocturia: a consensus statement. BJU Int. 2011;108(1):6–21.CrossRefPubMed

Cornu JN, Abrams P, Chapple CR, Dmochowski RR, Lemack GE, Michel MC, et al. A contemporary assessment of nocturia: definition, epidemiology, pathophysiology, and management—a systematic review and meta-analysis. Eur Urol. 2012;62(5):877–90.CrossRefPubMed

Welliver C, Sulaver R, Whittington A, Helfand BT, Cakir OO, Griffith JW, et al. Analyzing why men seek treatment for lower urinary tract symptoms and factors associated with nonimprovement. Urology. 2015;86(5):862–7.CrossRefPubMed

Boyle P, Gould AL, Roehrborn CG. Prostate volume predicts outcome of treatment of benign prostatic hyperplasia with finasteride: meta-analysis of randomized clinical trials. Urology. 1996;48(3):398–405.CrossRefPubMed

Marberger MJ, Andersen JT, Nickel JC, Malice MP, Gabriel M, Pappas F, et al. Prostate volume and serum prostate-specific antigen as predictors of acute urinary retention. Combined experience from three large multinational placebo-controlled trials. Eur Urol. 2000;38(5):563–8.CrossRefPubMed

Lieber MM, Jacobsen SJ, Roberts RO, Rhodes T, Girman CJ. Prostate volume and prostate-specific antigen in the absence of prostate cancer: a review of the relationship and prediction of long-term outcomes. Prostate. 2001;49(3):208–12.CrossRefPubMed

Jacobsen SJ, Jacobson DJ, Girman CJ, Roberts RO, Rhodes T, Guess HA, et al. Natural history of prostatism: risk factors for acute urinary retention. J Urol. 1997;158(2):481–7.CrossRefPubMed

Madersbacher S, Alivizatos G, Nordling J, Sanz CR, Emberton M, de la Rosette JJ. EAU 2004 guidelines on assessment, therapy and follow-up of men with lower urinary tract symptoms suggestive of benign prostatic obstruction (BPH guidelines). Eur Urol. 2004;46(5):547–54.CrossRefPubMed

McVary KT, Roehrborn CG, Avins AL, Barry MJ, Bruskewitz RC, Donnell RF, et al. Update on AUA guideline on the management of benign prostatic hyperplasia. J Urol. 2011;185(5):1793–803.CrossRefPubMed

10.

Bosch JL, Hop WC, Kirkels WJ, Schroder FH. The international prostate symptom score in a community-based sample of men between 55 and 74 years of age: prevalence and correlation of symptoms with age, prostate volume, flow rate and residual urine volume. Br J Urol. 1995;75(5):622–30.CrossRefPubMed

11.

Overland GB, Vatten L, Rhodes T, DeMuro C, Jacobsen G, Vada K, et al. Lower urinary tract symptoms, prostate volume and uroflow in norwegian community men. Eur Urol. 2001;39(1):36–41.CrossRefPubMed

12.

•• Simon RM, Howard LE, Moreira DM, Roehrborn C, Vidal AC, Castro-Santamaria R, et al. Does prostate size predict the development of incident lower urinary tract symptoms in men with mild to no current symptoms? Results from the REDUCE trial. Eur Urol. 2016;69(5):885–91. In this post hoc analysis of the REDUCE trial, the authors investigate the association of prostate size with development of incident LUTS in those men without existing symptoms. The authors find that prostate size 40-80cc is associated with a 67% increased risk of developing incident LUTS, a risk which is ameliorated by treatment with dutasteride. While previous studies have shown that large prostate size is associated with progression of BPH symptoms, this study importantely reveals a potential cohort without symptoms that would benefit from follow-up. CrossRefPubMed

13.

Meyhoff HH, Hald T. Are doctors able to assess prostatic size? Scand J Urol Nephrol. 1978;12(3):219–21.CrossRefPubMed

14.

Meyhoff HH, Ingemann L, Nordling J, Hald T. Accuracy in preoperative estimation of prostatic size. A comparative evaluation of rectal palpation, intravenous pyelography, urethral closure pressure profile recording and cystourethroscopy. Scand J Urol Nephrol. 1981;15(1):45–51.CrossRefPubMed

15.

Roehrborn CG, Girman CJ, Rhodes T, Hanson KA, Collins GN, Sech SM, et al. Correlation between prostate size estimated by digital rectal examination and measured by transrectal ultrasound. Urology. 1997;49(4):548–57.CrossRefPubMed

16.

Varenhorst E, Berglund K, Lofman O, Pedersen K. Inter-observer variation in assessment of the prostate by digital rectal examination. Br J Urol. 1993;72(2):173–6.CrossRefPubMed

17.

Roehrborn CG, Sech S, Montoya J, Rhodes T, Girman CJ. Interexaminer reliability and validity of a three-dimensional model to assess prostate volume by digital rectal examination. Urology. 2001;57(6):1087–92.CrossRefPubMed

18.

Bosch JL, Bohnen AM, Groeneveld FP. Validity of digital rectal examination and serum prostate specific antigen in the estimation of prostate volume in community-based men aged 50 to 78 years: the Krimpen study. Eur Urol. 2004;46(6):753–9.CrossRefPubMed

19.

•• Stone BV, Shoag J, Halpern JA, Mittal S, Lewicki P, Golombos DM, et al. Prostate size, nocturia and the digital rectal examination: a cohort study of 30 500 men. BJU international. 2016. This post hoc analysis of the PLCO trial investigates the accuracy and reliability of the DRE in assessing prostate size and the utility of prostate size in the workup of nocturia. In over 30,500 men, the authors demonstrate that the DRE is moderately reliable and correlates modestly with TRUS volume and PSA. Further, in a multivariable analysis of nocturia, cardiovascular comorbidities are more predictive than prostate size with regard to nocturia symptoms. This study importantly emphasizes the multifactorial nature of nocturia and the poor clinical utility of the DRE for this condition.

20.

Dani H, Esdaille A, Weiss JP. Nocturia: aetiology and treatment in adults. Nature reviews Urology. 2016;13(10):573–83.CrossRefPubMed

21.

Miranda Ede P, Gomes CM, Torricelli FC, de Bessa JJ, de Castro JE, Ferreira BR, et al. Nocturia is the lower urinary tract symptom with greatest impact on quality of life of men from a community setting. International neurourology journal. 2014;18(2):86–90.CrossRefPubMed

22.

Asplund R. Nocturia: consequences for sleep and daytime activities andassociated risks. Eur Urol Suppl. 2005;3(6):24–32.CrossRef

23.

Nakagawa H, Niu K, Hozawa A, Ikeda Y, Kaiho Y, Ohmori-Matsuda K, et al. Impact of nocturia on bone fracture and mortality in older individuals: a Japanese longitudinal cohort study. J Urol. 2010;184(4):1413–8.CrossRefPubMed

24.

Witthaus MW, Nipa F, Yang JH, Li Y, Lerner LB, Azadzoi KM. Bladder oxidative stress in sleep apnea contributes to detrusor instability and nocturia. J Urol. 2015;193(5):1692–9.CrossRefPubMed

25.

Fitzgerald MP, Litman HJ, Link CL, McKinlay JB. The association of nocturia with cardiac disease, diabetes, body mass index, age and diuretic use: results from the BACH survey. J Urol. 2007;177(4):1385–9.CrossRefPubMed

26.

Tikkinen KA, Auvinen A, Johnson 2nd TM, Weiss JP, Keranen T, Tiitinen A, et al. A systematic evaluation of factors associated with nocturia—the population-based FINNO study. Am J Epidemiol. 2009;170(3):361–8.CrossRefPubMedPubMedCentral

27.

Markland AD, Vaughan CP, Johnson 2nd TM, Goode PS, Redden DT, Burgio KL. Prevalence of nocturia in United States men: results from the National Health and Nutrition Examination Survey. J Urol. 2011;185(3):998–1002.CrossRefPubMed

28.

Blanker MH, Bohnen AM, Groeneveld FP, Bernsen RM, Prins A, Ruud Bosch JL. Normal voiding patterns and determinants of increased diurnal and nocturnal voiding frequency in elderly men. J Urol. 2000;164(4):1201–5.CrossRefPubMed

29.

Burgio KL, Johnson 2nd TM, Goode PS, Markland AD, Richter HE, Roth DL, et al. Prevalence and correlates of nocturia in community-dwelling older adults. J Am Geriatr Soc. 2010;58(5):861–6.CrossRefPubMedPubMedCentral

30.

Sze EH, Jones WP, Ferguson JL, Barker CD, Dolezal JM. Prevalence of urinary incontinence symptoms among black, white, and Hispanic women. Obstet Gynecol. 2002;99(4):572–5.PubMed

31.

Umlauf MG, Chasens ER, Greevy RA, Arnold J, Burgio KL, Pillion DJ. Obstructive sleep apnea, nocturia and polyuria in older adults. Sleep. 2004;27(1):139–44.CrossRefPubMed

32.

Sarma AV, Burke JP, Jacobson DJ, McGree ME, St Sauver J, Girman CJ, et al. Associations between diabetes and clinical markers of benign prostatic hyperplasia among community-dwelling black and white men. Diabetes Care. 2008;31(3):476–82.CrossRefPubMed

33.

Bing MH, Moller LA, Jennum P, Mortensen S, Lose G. Nocturia and associated morbidity in a Danish population of men and women aged 60-80 years. BJU Int. 2008;102(7):808–14. discussion 14-5 CrossRefPubMed

34.

•• Gacci M, Corona G, Vignozzi L, Salvi M, Serni S, De Nunzio C, et al. Metabolic syndrome and benign prostatic enlargement: a systematic review and meta-analysis. BJU Int. 2015;115(1):24–31. This meta-analysis of eight studies and 5403 patients investigates the relationship between metabolic syndrome and BPH-LUTS. The authors demonstrate that patients with metabolic syndrome have larger prostate volume, an effect which is significantly greater in older, obese, dyslipidemic patients. CrossRefPubMed

35.

De Nunzio C, Aronson W, Freedland SJ, Giovannucci E, Parsons JK. The correlation between metabolic syndrome and prostatic diseases. Eur Urol. 2012;61(3):560–70.CrossRefPubMed

36.

•• Muller RL, Gerber L, Moreira DM, Andriole Jr G, Hamilton RJ, Fleshner N, et al. Obesity is associated with increased prostate growth and attenuated prostate volume reduction by dutasteride. Eur Urol. 2013;63(6):1115–21. This post hoc analysis of the REDUCE trial demonstrates that obese men have higher rates of prostate volume growth and inferior reductions of prostate growth after treatment with dutasteride. This study supports the growing body of ltierature regarding the relationship between obesity, metabolic syndrome, and BPH. CrossRefPubMed

37.

•• Bouwman II, Blanker MH, Schouten BW, Bohnen AM, Nijman RJ, van der Heide WK, et al. Are lower urinary tract symptoms associated with cardiovascular disease in the Dutch general population? Results from the Krimpen study. World J Urol. 2015;33(5):669–76. This post hoc analysis of the Krimpen study further adds to the body of literature regarding cardiovascular comorbidities and BPH-LUTS. The authors reveal that patients with moderate to severe LUTS have singificantly increased odds of cardiovascular disease (OR 1.81, 95% CI 1.38-2.37). CrossRefPubMed

38.

Gratzke C, Bachmann A, Descazeaud A, Drake MJ, Madersbacher S, Mamoulakis C, et al. EAU guidelines on the assessment of non-neurogenic male lower urinary tract symptoms including benign prostatic obstruction. Eur Urol. 2015;67(6):1099–109.CrossRefPubMed

39.

• van Doorn B, Kok ET, Blanker MH, Westers P, Bosch JL. Determinants of nocturia: the Krimpen study. J Urol. 2014;191(4):1034–9. This study importantly evaluates nocturia not just in a cross-sectional study, but in a longitudinal population-based setting using frequency volume charts. The authors illustrate that low maximum voided volume, global polyuria, nocturnal polyuria, and lower urinary tract symptoms are potentially modifiable associations with nocturia in this population. CrossRefPubMed

Titel: Accurate Estimation of Prostate Size in the Evaluation of Nocturia
verfasst von: Benjamin V. Stone
Jonathan Shoag
Christopher E. Barbieri
Jim C. Hu
Richard K. Lee
Publikationsdatum: 25.03.2017
Verlag: Springer US
Erschienen in: Current Bladder Dysfunction Reports / Ausgabe 2/2017
Print ISSN: 1931-7212
Elektronische ISSN: 1931-7220
DOI: https://doi.org/10.1007/s11884-017-0420-9

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Abstract

Purpose of Review

Recent Findings

Summary

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