Can extra-urethral catheter length be a predictor of prostate weight and need for prostate surgery?

ABSTRACT

Introduction: It is a common observation patients with large prostatic have smaller visible length of the catheter. Study questions Does extraurethral catheter length (EUCL) have correlation with ultrasound prostate measurements? Can EUCL and clinical parameters predict need for prostate surgery?. Adult men on catheter for retention due to BPH were included. The EUCL was measured from the external urethral meatus to the end of the catheter. Detailed clinical and Ultrasound measurements like intravesical prostate protrusion (IPP), transverse prostate width (TPW), axial prostate length (APL), sagittal prostate maximum length (SPL), prostate weight (PW) were performed. Retention while on alpha blockers and failed voiding trial with alpha blockers were the indications for surgery. Need for surgery was classified as pass/fail. Machine learning decision tree analysis in 80/20 fashion was done using python and scikit. Ethics committee approval taken. Result(s) 110 patients were recruited (Jul 18-Mar 20, recruitment stopped due to COVID related restrictions) EUCL had a negative relationship with IPP, TPW, APL, SPL, PW. Retention episode while on alpha blocker and EUCL smaller than 169 mm were the strongest predictors for need for surgery. Conclusion(s) As the prostate increased in size EUCL decreased. Retention while on alpha blocker and EUCL <169 mm predicted the need for surgery. EUCL may be used at primary healthcare setting especially in resource poor setting as surrogate marker for prostate size and need for surgery.