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Lower urinary tract symptoms (LUTS) are one of most frequent complaints among men over 50 years of age. LUTS are usually associated with benign prostate hyperplasia, however may accompany prostate cancer (PCa). Therefore, part of men subjected to prostate biopsy (Bx) usually have some degree of LUTS. The aim of the study is to evaluate prospectively the incidence of LUTS and theirs character in men subjected to prostate core Bx, and finally to determine whether LUTS can be used as a predictive factor of PCa discovering on prostate Bx.
Material and Methods
Data of men submitted to transrectal ultrasound guided multiple core biopsy of the prostate (TRUScoreBx) from 1st July 2007 to 30th July 2008 in selected departments of urology in Poland were analyzed. LUTS were measured with International Prostate Symptom Score (I-PSS).
TRUScoreBx was performed in 747 men aged between 34 and 93 years (mean − 67.4, median − 68). Mild LUTS or no LUTS 7 I-PSS points) have been reported by 29.5% of patients. PCa was found in ≤60.0% of them. Among men with moderate or severe LUTS (I-PSS >7 points) PCa was found in 51.4% and 55.0% of them respectively. Median PSA was 9.5 ng/ml, 9.4 ng/ml and 12.0 ng/ml in men with mild and moderate or severe LUTS respectively (NS). However, among men with severe LUTS PCa was more likely to be locally advanced than in men with mild symptoms.
LUTS are weak predictor, if any, of positive result of core biopsy of the prostate. However, PCa is diagnosed less frequently among men subjected to prostate biopsy in whom LUTS are moderate or severe. Moreover, there is a trend to diagnose locally advanced cancer more frequently in men with severe LUTS.