Comparison of the effect of prostate volume and prostate specific antigen on severity of lower urinary tract symptoms among adult men in the community

Background: Baseline prostate volume(PV) and Prostate specific antigen(PSA) level are important variables in the progression of lower urinary tract symptoms(LUTS) in benign prostatic hyperplasia(BPH) patients and have correlations to urine flow. Both determine response to medical therapy and predict the incidence of acute urinary retention. In this study, we compared the influence of prostate volume against that of PSA on LUTS. Method: This was a prospective community-based study among men 40 years and above between 2023 and 2024. We assessed LUTS with international prostate symptoms score(IPSS). The quantitative PSA of participants was determined using ELISA method. PV was determined using 3.5MHz USS-probe. Chi-square test and multiple-logistics-regression and odds ratio were used to determine the relationship and strength of association between PV and PSA with various categories of LUTS respectively. Correlation between PV and PSA was also done using Spearman’s correlation coefficient. Statistical significance was determined at p-value ≤0.05. Result: PSA distribution showed significant difference across severity levels of LUTS (χ2=18.52, p=0.005), most participants with mild LUTS having PSA<4 compared to those with moderate and severe LUTS. Similarly, there was significant discrepancy in the distribution of PV (χ2=35.81, p< 0.0001), with higher proportion of participants in severe LUTS category exhibiting severely enlarged prostates. After adjusting for other variables there was greater increase on the influence of PSA on LUTS. Conclusion; Both PSA and PV significantly determine severity of LUTS however PSA is a greater influencer of LUTS than PV. PV positively correlates PSA value.