Significant intravesical prostatic protrusion and prostatic calcification predict unfavorable outcomes of medical treatment for male lower urinary tract symptoms

To evaluate the impact of intravesical prostatic protrusion (IPP) and prostatic calcification on medical treatment for male lower urinary tract symptoms (LUTS). Men over the age of 40 years with total International Prostate Symptom Score (IPSS) ≥ 8 were recruited from January to August 2013. The maximal flow rate, postvoiding residual (PVR) urine volume, total prostate volume (TPV), transitional zone volume (TZV), transitional zone index (TZI), and grades of IPP and prostate calcification were recorded. All patients received α-blocker monotherapy, and Global Response Assessment (GRA) was used to determine treatment response 1 month after the treatment. The primary end point was to compare the treatment results in patients with and without significant IPP or prostate calcification. Univariate and multivariate logistic regression analyses were performed to determine whether IPP and prostatic calcification are predictors of improved outcome (GRA ≥ 1). We enrolled 112 men with a mean age of 65.5 (range, 42–89) years. IPP was significantly positively correlated with TPV, TZV, TZI, and PVR. Prostatic calcification was significantly negatively correlated with total IPSS, IPSS Voiding, and IPSS Storage. After 1-month treatment with α-blockers, the average total IPSS decreased from 18.2 ± 7.4 to 13.1 ± 4.5. Sixty-nine patients (61.6%) reported improved outcomes. Patients with large prostate volumes (TPV ≥ 40 mL) and small prostate volumes (TPV