MP71-18 LOW-VOLUME PROSTATE IN BENIGN PROSTATIC HYPERPLASIA (BPH): A RISK FACTOR FOR SYMPTOMATIC BLADDER DIVERTICULA REQUIRING SURGICAL TREATMENT

INTRODUCTION AND OBJECTIVES: to evaluate the association between prostate volume, age, and occurrence of bladder diverticula requiring surgical treatment on patients with symptomatic BPH. METHODS: we performed a retrospective search on our prospectively collected database searching for patients with BPH managed surgically between Jan/10 and Oct/14. Analyzed data comprised age at, prostatic volume measured on abdominal ultrasound, type of prostatic surgery, and presence of bladder diverticula requiring surgical treatment ( 3cm and/or symptomatic). Patients were divided in regards to diverticula requiring surgical treatment. Groups were compared using Student T test and Chi-square/Fisher exact test. Logistic regression was performed to seek for associations between the presence of the symptomatic diverticula and preoperative parameters. Significance was set at p<0.05. RESULTS: A total of 1532 patients were surgically treated for BPH in the analyzed period and 41 (2.6%) had symptomatic bladder diverticula. Mean diverticula size was 6.8 2.9cm and mean number of diverticula per patient was 1.5 0.8 (1-5). Treatment of the diverticula was performed laparoscopically in 13 (31.8%) patients, by endoscopic incision in 14 (34.1%), and by open resection in 14 cases (34.1%). Patients with treated diverticula did not differ from the other cohort in regards to age (66.9 8.3 vs. 68.5 8.8 years, respectively; p1⁄40.16) and surgical technique (p1⁄40.11). Mean prostate volume was significantly lower in the treated diverticula group (53.6 45.0 vs. 80.7 51.9g, respectively; p<0.01). Prostate volume and age distributions among patients with and without diverticula are depicted in figures 1A and B. Logistic regression revealed only prostate volume to significantly impact the presence of symptomatic diverticula requiring surgical treatment (OR1⁄4-0.03; 95% CI 0.955 e 0.988; p1⁄40.01). Roc curve analysis revealed a significant association with an AUC of 0.73 (p<0.001)(fig.1c). CONCLUSIONS: In patients with BPH, there is a significant association between prostate volume and risk of symptomatic bladder diverticulum. Bladder diverticula requiring surgical treatment are more common in patients with low prostate volume.