Lower Urinary Tract Symptoms and Benign Prostate Hyperpasia Features among Male BRCA Mutation Carriers

• Published in: Urology (Ridgewood, N.J.) N.J.), 2017
• Main Authors: Goldberg, Hanan, MD, Shavit Grievink, Liat, PhD, Mano, Roy, MD, Bar, Yeara, PhD, Ozalbo, Rachely, PhD, Tuval, Sivan, Msc, Baniel, Jack, MD, Margel, David, PhD, MD
• Format: Article
• Language: English
• Subjects: Urology
• ISSN: 0090-4295
• DOI: 10.1016/j.urology.2017.05.036

Abstract Objective To analyze lower urinary tract symptoms (LUTS) and benign prostate hyperplasia (BPH) features among male BRCA 1 and 2 carriers and an age matched control group. Patients and Methods Male BRCA carriers and non-carriers aged 40-70 were enrolled in our cross sectional study. Relevant clinical data was collected and patients filled the international prostate symptoms questionnaire. Patients also underwent PSA blood testing, digital rectal examination, uroflowmetry and post void residual (PVR) ultrasound examination. As part of their routine follow-up, BRCA carriers underwent prostate MRI. Results Overall 87 carriers and 30 non-carriers were enrolled. The median age, mean BMI and comorbidities in both groups were similar. Maximal flow (Qmax) was higher in the non-carrier group (16.9 ml/sec vs. 12 ml/sec, p=0.01). Mean prostate volume among all BRCA carriers was 38.8 cc (19.7), but BRCA 1 patients had larger glands with higher mean PSA and PSA density than BRCA 2 patients (41.8 cc vs. 33.1 cc, p=0.047, 1.84 ng/ml vs. 1.07 ng/ml, p=0.006, and 0.044 vs. 0.032, p=0.042 respectively). Multivariate analysis demonstrated age being the sole significant predictor of PSA density in BRCA 2 patients. Conclusions Male carrying BRCA mutations have significantly lower Qmax than healthy men. BRCA 1 patients have on average larger prostate glands and higher PSA than BRCA 2 patients. Further research is required to decipher the association of LUTS/BPH to BRCA carriers.