利用前列腺尿道角度預測前列腺分區交界鈣化: 電腦斷層影像研究

陳約任^1*、陳昱廷^1*、陳建綸¹、侯鎮邦¹、曹書瀚¹、蔡翰宇¹、林友翔¹

¹林口長庚紀念醫院泌尿科

^*共同第一作者

Predictive Value of Prostate Urethral Angle for the Presence of Prostatic Surgical Capsule Calcification: A Computed Tomography-based Study

Jonathan YJ Chen^1*, Yu-Ting Chen^1*, Chien-lun Chen¹, Chen-Pang Hou¹, Shu-Han Tsao¹, Han-Yu Tsai¹, Yu-Hsiang Lin¹

¹ Divisions of Urology, Department of Surgery, Chang-Gung Medical Foundation Linkou Chang-Gung Memorial Hospital

^* Co-first author

Purpose:

Prostatic calculi have been established as correlated with the aggravation of lower urinary tract symptoms in males. Endeavors have been undertaken to elucidate the specific mechanisms underlying calculi formation. The Prostate Urethral Angle (PUA) has been investigated for its inverse correlation with urinary flow rate, attributed to energy loss within the prostatic urethra. Consequently, we hypothesized that heightened energy loss within the prostatic urethra may facilitate intra-prostatic urine reflux, thereby promoting calculi formation. Thus, this study was devised to examine the predictive role of PUA in the presence of prostatic surgical capsule calcification.

Materials and Methods:

This retrospective study evaluated a cohort of male patients aged 18 years and above who presented to the emergency department of Chang Gung Memorial Hospital, Linkou branch, during October 2023 and underwent abdomen to pelvis computed tomography (CT) scans for any indication. Exclusion criteria encompassed patients with prostate cancer, those who had undergone prostate surgery such as transurethral resection of the prostate, and individuals with end-stage renal disease. The presence of prostatic surgical capsule calcification was documented based on CT findings. Characteristics including age, body mass index (BMI), PUA, prostate volume, Intravesical Prostatic Protrusion (IPP) length, and bladder stones were recorded for subsequent analysis.

Results:

A total of 125 patients were enrolled in the analysis, among whom 51 were diagnosed with prostatic surgical capsule calcification. There were significant differences in age (p<0.001) and prostate urethral angle (PUA) (p<0.001) between the patient groups with and without prostate surgical capsule calcification. However, no statistically significant differences were found in terms of body mass index (BMI), prostate volume, intravesical prostatic protrusion and the presence of bladder stones. Univariate analysis demonstrated significant correlations between age (p< 0.001) and PUA (p< 0.001) with the presence of prostatic surgical capsule calcification. Subsequent multivariate analysis indicated that age (95% CI: 1.010-1.068, p=0.008) and PUA (95% CI: 1.028-1.113, p< 0.001) maintained statistically significant associations with prostatic surgical capsule calcification presentation.

Conclusions:

The PUA and age demonstrated correlations with the incidence of prostatic surgical capsule calcification. These findings may serve as valuable clinical tools for predicting the presence of prostate calcifications.