Absence of Bladder Outlet Obstruction Is an Independent Risk Factor for Prostate Cancer in Men Undergoing Prostate Biopsy

Overview

Journal Medicine (Baltimore)

Specialty General Medicine

Date 2016 Feb 18

PMID 26886598

Citations 15

Authors

Luigi Cormio

Giuseppe Lucarelli

Oscar Selvaggio

Giuseppe Di Fino

Vito Mancini

Paolo Massenio

Francesco Troiano

Francesca Sanguedolce

Pantaleo Bufo

Giuseppe Carrieri

Affiliations

Soon will be listed here.

Abstract

The purpose of this study was to investigate the relationship between bladder outlet obstruction (BOO) and the risk of being diagnosed with prostate cancer (PCa).Study population consisted of 2673 patients scheduled for the first prostate biopsy (PBx). All patients underwent uroflowmetry before PBx; those with a peak flow rate (PFR) <10 mL/s were considered to have BOO.The incidence of PCa was 41.3% (1104/2673) in the overall population and 34.1% (659/1905) in patients with serum prostate-specific antigen (PSA) ≤ 10 ng/mL. Univariate and multivariate logistic regression analyses showed that patients with BOO had a significantly (P < 0.0001) lower risk than those without BOO of being diagnosed with PCa (33.1% vs 66.9% in the overall population; 30% vs 70% in patients with PSA ≤ 10 ng/mL). As the presence of BOO was significantly correlated to a large prostate volume, another independent predictor of PBx outcome, we tested whether these parameters could be used to identify, in the subset of patients with PSA≤10 ng/mL, those who could potentially be spared from a PBx. If we would have not biopsied patients with BOO and prostate volume ≥60 mL, 14.5% of biopsies could have been avoided while missing only 6% of tumors. Only 10% of the tumors that would have been missed were high-risk cancers.In conclusion, in men undergoing PBx, the absence of BOO, as determined by a PFR ≥10 mL/s, is an independent risk factor for PCa. Our study provides ground for this simple, noninvasive, objective parameter being used, alone or in combination with prostate volume, in the decision-making process of men potentially facing a PBx.

Citing Articles

Does bladder outflow obstruction obfuscate the traditional clinical factors that are used to assess the risk of prostate cancer at rapid-access diagnostic clinics?.

Cahill T, Withey S, Hazell S, Cahill D, Kinsella N BJUI Compass. 2025; 6(1):e478.

PMID: 39877561 PMC: 11771501. DOI: 10.1002/bco2.478.

Foggia Prostate Cancer Risk Calculator 2.0: A Novel Risk Calculator including MRI and Bladder Outlet Obstruction Parameters to Reduce Unnecessary Biopsies.

Falagario U, Busetto G, Recchia M, Tocci E, Selvaggio O, Ninivaggi A Int J Mol Sci. 2023; 24(3).

PMID: 36768769 PMC: 9917125. DOI: 10.3390/ijms24032449.

A Matched-Pair Analysis after Robotic and Retropubic Radical Prostatectomy: A New Definition of Continence and the Impact of Different Surgical Techniques.

dAltilia N, Mancini V, Falagario U, Martino L, Di Nauta M, Calo B Cancers (Basel). 2022; 14(18).

PMID: 36139511 PMC: 9496957. DOI: 10.3390/cancers14184350.

One-Day Prostate Cancer Diagnosis: Biparametric Magnetic Resonance Imaging and Digital Pathology by Fluorescence Confocal Microscopy.

Falagario U, Selvaggio O, Sanguedolce F, Milillo P, Sighinolfi M, Bruno S Diagnostics (Basel). 2022; 12(2).

PMID: 35204368 PMC: 8871204. DOI: 10.3390/diagnostics12020277.

Intraoperative Digital Analysis of Ablation Margins (DAAM) by Fluorescent Confocal Microscopy to Improve Partial Prostate Gland Cryoablation Outcomes.

Selvaggio O, Falagario U, Bruno S, Recchia M, Sighinolfi M, Sanguedolce F Cancers (Basel). 2021; 13(17).

PMID: 34503192 PMC: 8431702. DOI: 10.3390/cancers13174382.

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