Clinical performance of prostate health index in men with tPSA>10ng/ml: Results from a multicentric European study.
OBJECTIVES To evaluate how often benign prostatic hyperplasia (BPH) was diagnosed in men referred as a result of lower urinary tract symptoms (LUTS) and to investigate the correlation between prostate volume and serum prostate-specific antigen (s-PSA). MATERIAL AND METHODS The study subjects comprised men (n = 119; mean age 68 years) consecutively referred to a urological clinic as a result of LUTS for whom the information in the referral forms gave no indications of malignant disease or infection. The patients were evaluated according to regional guidelines. RESULTS BPH was estimated to be the main etiological agent in less than every second man. There was a statistically significant correlation between s-PSA and prostate size. However, among men with s-PSA < 1.5 ng/ml, one-third had a prostate volume of > 30 ml and 17% a prostate volume of > 40 ml. Among men with s-PSA > or = 1.5 ng/ml, as many as 18% had a prostate volume of < or = 30 ml and 42% a prostate volume of < or = 40 ml. Bladder and/or prostate cancer was diagnosed in 8% of men, mostly as a coincidental finding. CONCLUSIONS BPH was considered to be the etiological factor in < 50% of men referred as a result of LUTS. The correlation between prostate volume and s-PSA was verified. However, interindividual variation in s-PSA was so large that its usefulness for making treatment decisions in men with LUTS must be questioned.