The impact of quantification and distribution of prostatic calculi by computed tomography scan on lower urinary tract symptoms: a retrospective study

Background: To evaluate the volume and distribution of prostatic calculi (PC) and to examine its relationship with the international prostate symptom score (IPSS), QOL score, overactive bladder symptom score (OABSS), and urinary flow test. Methods: We conducted a retrospective study of patients who visited the urology outpatient department of our hospital mainly for LUTS or medical examinations abnormalities. PC in computed tomography (CT) scans was quantified using a 3D image analysis system (VINCENT). We also evaluated whether the site of PC was periurethral or not, and distal or proximal. Results: A total of 318 patients with a mean age of 70.4 years and mean prostate volume of 44.2 ml were enrolled. CT revealed PC in 217 patients (68.2%). The IPSS, QOL score, and OABSS were significantly higher in the PC group than those in the non-PC group. PC volume showed a significant positive correlation with IPSS storage score (p=0.02). PC volume was an independent factor for IPSS storage score and OABSS in multiple regression analysis (p< 0.01). Among the PC groups, the periurethral calculi (PUC) group had significantly higher IPSS storage and OABSS than those in the non-PUC group (p=0.011 and p=0.007, respectively). Furthermore, among the PUC groups, when the calcification site was divided into proximal and distal sites, the IPSS and OABSS were significantly higher in the distal group than those in the proximal group (p=0.023 and p=0.010, respectively). Conclusions: Increased PC volume and PUC, especially at the distal site, were significantly associated with worsening urinary storage symptoms.