Larger Prostates Predict Higher Risk of Lower Urinary Tract Symptoms

The risk is 67% higher in men with a prostate size of 40.1-80 mL than those with smaller glands.
The risk is 67% higher in men with a prostate size of 40.1-80 mL than those with smaller glands.

Lower urinary tract symptoms (LUTS) are more likely to develop in men with larger prostates, according to a post hoc analysis of data from the REDUCE trial.

The randomized, double-blind trial compared the effect of dutasteride versus placebo on reducing the risk of prostate cancer. The post hoc analysis, led by Stephen J. Freedland, MD, of the Cedars-Sinai Medical Center in Los Angeles, included 3,090 participants with mild to no LUTS at baseline. Among the 1,550 placebo recipients, those with a baseline prostate size of 40.1–80 mL had a significant 67% increased risk of developing incident LUTS compared with men who had smaller prostates, after adjusting for potential confounders, the researchers reported online ahead of print in European Urology. Each 10 mL increment in baseline prostate size was associated with a significant 12% increased risk of incident LUTS. The investigators observed no association between prostate size and incident LUTS risk among the 1,540 dutasteride recipients.

The researchers defined mild to no LUTS using an International Prostate Symptom Score (IPSS) less than 8. They defined incident LUTS as the first report of medical treatment, surgery, or sustain, clinically significant benign prostatic hyperplasia (BPH) symptoms.

“Our findings suggest that the question of whether or not there is clinical utility in being able to predict incident LUTS in a man with mild to no symptoms must be discussed,” Dr. Freedland's team wrote. “First, and most importantly, such a prediction could potentially allow for closer follow-up in a man who perhaps would not normally be followed for LUTS/BPH because of few current symptoms.”

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