Ultrasound-estimated bladder weight predicts need for RP in BPH patients

An estimate of bladder weight using ultrasound can help predict both which patients with BPH will eventually require a prostatectomy and which ones will have favorable outcomes following the procedure, according to a Japanese study.

Ultrasound-estimated bladder weight, or USEBW, "is a useful parameter to predict the outcome of prostatectomy," said lead author Hironobu Akino, MD, associate professor at the University of Fukui. He presented the results of the study here yesterday.

Dr. Akino and colleagues estimated the USEBW of 97 men over 50 years of age who presented with lower urinary tract symptoms suggestive of BPH using transabdominal ultrasound. All patients received an alpha-adrenoceptor blocker as first-line therapy.

Overall, 37 of the 97 patients eventually underwent prostatectomy. Patients were more likely to undergo prostatectomy if they had a USEBW of 35 grams or more and if they had severe LUTS, defined as an International Prostate Symptom Score of 20 or more. The incidence of prostatectomy in patients with a USEBW of 35 grams or greater was 78%, compared with only 36% in those with a USEBW under 35 grams. Both high USEBW and severe LUTS were identified as significant risk factors for prostatectomy in multivariate analysis.

Among the 37 patients who underwent a prostatectomy, seven were taking a cholinergic drug to improve their LUTS 3 months post-surgery, which indicates a poor surgical outcome. Both USEBW and prostate volume, but not severity of LUTS, predicted a poor surgical outcome following prostatectomy. Only one of 25 patients with a USEBW of 35 grams or more had a poor outcome following prostatectomy, compared with six out of the 12 patients with a lower USEBW.

Based on these findings, USEBW is an effective, noninvasive tool for predicting the need for prostatectomy that is independent of both prostate volume and LUTS, according to Dr. Akino.