Kusuma Duarsa Gede Wirya, Sari Yudit Anastasia, Gde Oka Anak Agung, Santosa Kadek Budi, Yudiana I Wayan, Wisnu Tirtayasa Pande Made, Putra Pramana Ida Bagus, Kloping Yudhistira Pradnyan
Department of Urology, Sanglah General Hospital, Faculty of Medical and Health Sciences of Udayana University, Denpasar, Bali, Indonesia.
General Surgery Department, Faculty of Medicine Udayana University, Denpasar, Bali, Indonesia.
Asian J Urol. 2021 Jul;8(3):289-297. doi: 10.1016/j.ajur.2020.06.001. Epub 2020 Jun 7.
Benign prostatic hyperplasia (BPH) is one of the most common diseases found among elderly men. Even though multiple risk factors of BPH have been identified in the past, the risk factors which have a direct impact on prostate volume have not been identified. In this study, we aim to determine the most significant contributing risk factors to prostate volume enlargement by analyzing possible associated risk factors previously studied.
This is a quantitative study with an analytical observational design, performed using a retrospective cohort approach. Total sampling was performed on 83 patients who underwent transurethral resection of the prostate (TURP) in Sanglah General Hospital from January to February 2019. Bivariate analysis is performed to examine each variable's association with prostate volume followed by a multivariate analysis. All variables were reassessed with path analysis to measure the direct effects, indirect effects, and total effects on prostate volume.
Bivariate analysis shows that serum testosterone (R=0.208; =0.059) and prostate-specific antigen (PSA) level (R=0.626; =0.001) have a significant association with prostate volume. Multivariate analysis shows that serum PSA (B=1.4; =0.001; 95% confidence interval [95% CI]=1.039-1.770) and testosterone (B=0.024; =0.005; 95% CI=0.008-0.041) levels are significant among all the analyzed risk factors. There is a significant and strong effect of PSA to prostate volume (c=0.636; =0.001) whereas testosterone has a significant albeit weak effect to prostate volume (c=0.246; =0.009) based on the total effect of the path analysis.
Serum testosterone and PSA levels are significantly associated with prostatic volume increase among BPH patients.
良性前列腺增生（BPH）是老年男性中最常见的疾病之一。尽管过去已确定了BPH的多种风险因素，但尚未确定对前列腺体积有直接影响的风险因素。在本研究中，我们旨在通过分析先前研究的可能相关风险因素，确定导致前列腺体积增大的最主要风险因素。
这是一项采用分析性观察设计的定量研究，采用回顾性队列研究方法。对2019年1月至2月在桑格拉总医院接受经尿道前列腺切除术（TURP）的83例患者进行了全样本抽样。进行双变量分析以检查每个变量与前列腺体积的关联，随后进行多变量分析。所有变量均通过路径分析重新评估，以测量对前列腺体积的直接效应、间接效应和总效应。
双变量分析显示，血清睾酮（R = 0.208；P = 0.059）和前列腺特异性抗原（PSA）水平（R = 0.626；P = 0.001）与前列腺体积有显著关联。多变量分析显示，在所有分析的风险因素中，血清PSA（B = 1.4；P = 0.001；95%置信区间[95%CI] = 1.039 - 1.770）和睾酮（B = 0.024；P = 0.005；95%CI = 0.008 - 0.041）水平具有显著性。根据路径分析的总效应，PSA对前列腺体积有显著且强烈的影响（c = 0.636；P = 0.001），而睾酮对前列腺体积有显著但较弱的影响（c = 0.246；P = 0.009）。
BPH患者血清睾酮和PSA水平与前列腺体积增加显著相关。
