Bladder Detrusor Muscular Ring Size on Magnetic Resonance Imaging is Associated With Moderate and Severe American Urological Association Symptom Index Scores in Untreated Men With Benign Prostatic Hyperplasia - A Potential Novel Predictor of Lower Urinary Tract Symptoms

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Conference Proceeding

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Journal of Urology


INTRODUCTION AND OBJECTIVE: The etiology of lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia(BPH) remains uncertain. The purpose of our study was to quantitatively analyze anatomic characteristics on magnetic resonance imaging (MRI)to assess novel independent factors for LUTS. METHODS: This retrospective single-institution study evaluated treatment-naïve men who underwent prostate MRI within 3 months of American Urological Association Symptom Index (AUASI) scoring from June 2021 to September 2022. Factors measured on MRI included: size of the detrusor muscular ring (DMR) surrounding the bladder outlet, prostate volume, intravesicular prostate protrusion (IPP) volume, and prostate urethra angle (PUA). Multivariable logistic regression and ROC analysis were used to analyze factors for moderate/severe (AUASI≥8) and severe LUTS (AUASI≥20).RESULTS: 318 total men (mean age: 66.2 (SD:8.0)) were included: 31 with severe symptoms, 131 with moderate symptoms, and 156 with mild symptoms. Increasing age (p=0.02;OR:1.05(1.01-1.08)),PUA (p=0.02;OR:1.05(1.01-1.09), and DMR size measured as diameter (p<0.001;OR:5.6(3.37-9.16)) were significantly independently associated with AUASI≥8. For every one cm increase in DMR diameter, patients had approximately five times the odds for AUASI≥8. Increasing DMR size (diameter p<0.001;OR: 2.74 (1.76-4.27) was independently associated with severe symptoms. CONCLUSIONS: Expansion of the detrusor muscular ring surrounding the bladder outlet is a novel anatomic factor independently associated with moderate/severe LUTS. Prostate volume and IPP volume were unrelated to AUASI scoring.





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American Urological Association Annual Meeting, April 28 - May 1, 2023, Chicago, IL