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Natural history of benign prostatic enlargement: long‐term longitudinal population‐based study of prostate volume doubling times
Author(s) -
Lieber Michael M.,
Rhodes Thomas,
Jacobson Debra J.,
McGree Michaela E.,
Girman Cynthia J.,
Jacobsen Steven J.,
St. Sauver Jennifer L.
Publication year - 2010
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/j.1464-410x.2009.08719.x
Subject(s) - percentile , medicine , prostate , cohort , prostate cancer , urology , population , prostate specific antigen , transrectal ultrasonography , gynecology , cancer , statistics , mathematics , environmental health
Study Type – Prognosis (cohort)
Level of Evidence 2a OBJECTIVES To measure prostate volume doubling times (PVDTs) for a large sample of community men followed serially by transrectal ultrasonography (TRUS), and to determine whether specific characteristics are associated with a rapid PVDT. SUBJECTS AND METHODS A subsample of 446 subjects from a larger cohort of American white men aged 40–79 years were evaluated biennially for a median (range) follow‐up of 10 (3–14) years. Mixed‐effects regression models were used to estimate prostate growth rates and PVDT for subjects with three or more or with five or more serial biennial TRUS PV measurements. RESULTS The median (25–75th percentile) PVDT was 32.6 (24.6–44.0) years. The average annual increase in PV was 2.2%. The PVDT distribution was constant in men of all age groups studied ( r < 0.001, P = 0.99). The factor most strongly associated with PVDT was baseline transition zone volume ( r = −0.55, P < 0.001). Baseline total prostate‐specific antigen (PSA) level, free PSA and total PV were also significantly inversely associated with PVDT ( r = −0.30, −0.44 and −0.32, respectively, all P < 0.001). Age, baseline anthropomorphic measurements, hormone levels and specific lifestyle characteristics were not significantly correlated with PVDT. CONCLUSION These data indicate that PVDT might be a useful future measure of benign prostatic growth. They provide a basis to forecast PV at 10, 20, or 30 years later, after one baseline TRUS measurement of prostate volume, and can be presented in a simple nomogram.