Gastroenterol Res

Gastroenterology Research, ISSN 1918-2805 print, 1918-2813 online, Open Access

Article copyright, the authors; Journal compilation copyright, Gastroenterol Res and Elmer Press Inc

Journal website http://www.gastrores.org

Original Article

Volume 11, Number 1, February 2018, pages 5-10

Clinical Implication of Enlarged Prostate in Patients with the Ileal Pouch-anal Anastomosis for Inflammatory Bowel Disease

Figure 1. Axial (left) and coronal (right) MRI images showing the methodology for measurement of prostate volume: anterior-posterior diameter (A-B) of 46 mm, width (transverse) (C-D) of 62 mm, and height (cranio-caudal) (E-F) of 62 mm.

**Table 1.** Association of Enlarged Prostate and General Clinical Variables
Variable	Enlarged (n = 58)	Normal (n = 176)	P value
Age at prostate volume measurement	55.6 ± 11.5	41.3 ± 13.6	< 0.0001
Age at ulcerative colitis diagnosis	33.9 ± 12.4	23.7 ± 11.7	< 0.0001
Smoker	14 (24.1%)	32 (18.2%)	0.34
Chronic non-steroidal anti-inflammatory drug use	4 (6.9%)	11 (6.2%)	0.99
Concurrent autoimmune disease	7 (12.1%)	25 (14.2%)	0.83

Table 1. Association of Enlarged Prostate and General Clinical Variables

Variable

Enlarged (n = 58)

Normal (n = 176)

P value

Age at prostate volume measurement

55.6 ± 11.5

41.3 ± 13.6

< 0.0001

Age at ulcerative colitis diagnosis

33.9 ± 12.4

23.7 ± 11.7

< 0.0001

Smoker

14 (24.1%)

32 (18.2%)

0.34

Chronic non-steroidal anti-inflammatory drug use

4 (6.9%)

11 (6.2%)

0.99

Concurrent autoimmune disease

7 (12.1%)

25 (14.2%)

0.83

**Table 2.** Association of Enlarged Prostate and Underlying Inflammatory Bowel Disease Characteristics
Variable	Enlarged prostate (n = 58)	Normal prostate (n = 176)	P value
Family history of inflammatory bowel disease			0.53
None	44 (75.9%)	146 (83%)
Crohn’s disease	3 (5.2%)	8 (4.5%)
Ulcerative colitis	11 (19%)	21 (11.9%)
Both	0 (0%)	1 (0.6%)
Indication for colectomy			0.18
Refractory	47 (81%)	155 (88.1%)
Dysplasia	11 (19%)	21 (11.9%)
Preoperative diagnosis			0.69
Ulcerative colitis	54 (93.1%)	160 (90.9%)
Indeterminate colitis	4 (6.9%)	14 (8%)
Crohn’s colitis	0 (0%)	2 (1.1%)
Extent of IBD			0.86
Pancolitis	54 (93.1%)	165 (93.8%)
Left colitis/proctitis	4 (6.9%)	11 (6.2%)
Toxic megacolon	6 (10.3%)	16 (9.1%)	0.77
Preoperative biological therapy	7 (12.1%)	34 (19.3%)	0.20

Table 2. Association of Enlarged Prostate and Underlying Inflammatory Bowel Disease Characteristics

Variable

Enlarged prostate (n = 58)

Normal prostate (n = 176)

P value

Family history of inflammatory bowel disease

0.53

None

44 (75.9%)

146 (83%)

Crohn’s disease

3 (5.2%)

8 (4.5%)

Ulcerative colitis

11 (19%)

21 (11.9%)

Both

0 (0%)

1 (0.6%)

Indication for colectomy

0.18

Refractory

47 (81%)

155 (88.1%)

Dysplasia

11 (19%)

21 (11.9%)

Preoperative diagnosis

0.69

Ulcerative colitis

54 (93.1%)

160 (90.9%)

Indeterminate colitis

4 (6.9%)

14 (8%)

Crohn’s colitis

0 (0%)

2 (1.1%)

Extent of IBD

0.86

Pancolitis

54 (93.1%)

165 (93.8%)

Left colitis/proctitis

4 (6.9%)

11 (6.2%)

Toxic megacolon

6 (10.3%)

16 (9.1%)

0.77

Preoperative biological therapy

7 (12.1%)

34 (19.3%)

0.20

**Table 3.** Association of Enlarged Prostate and Pouch-related Features
Variable	Enlarged (n=58)	Normal (n=176)	P value
Stage of pouch surgery			0.84
1	0 (0%)	2 (1.1%)
2	29 (50%)	93 (52.8%)
3	17 (29.3%)	53 (30.1%)
Redo pouch	12 (20.7%)	28 (15.9%)
Duration of pouch construction to last visit	10.1 ± 5.8	9.1 ± 6.2	0.27
Pouch type			0.02
J-pouch	54 (93.1%)	174 (98.9%)
S-pouch	4 (6.9%)	2 (1.1%)
Postoperative immunomodulators	4 (6.9%)	26 (14.8%)	0.47
Postoperative use of biologics	3 (5.2%)	30 (17%)	0.02
Final pouch condition			0.15
Normal	3 (5.2%)	10 (5.7%)
Irritable pouch syndrome	8 (13.8%)	22 (12.5%)
Active pouchitis	11 (19%)	16 (9.1%)
Refractory pouchitis	11 (19%)	29 (16.5%)
Crohn’s disease	10 (17.2%)	49 (27.8%)
Cuffitis	8 (13.8%)	14 (8%)
Surgical complications	7 (12.1%)	36 (20.5%)
Pouch failure	6 (10.3%)	29 (16.5%)	0.30

Table 3. Association of Enlarged Prostate and Pouch-related Features

Variable

Enlarged (n=58)

Normal (n=176)

P value

Stage of pouch surgery

0.84

0 (0%)

2 (1.1%)

29 (50%)

93 (52.8%)

17 (29.3%)

53 (30.1%)

Redo pouch

12 (20.7%)

28 (15.9%)

Duration of pouch construction to last visit

10.1 ± 5.8

9.1 ± 6.2

0.27

Pouch type

0.02

J-pouch

54 (93.1%)

174 (98.9%)

S-pouch

4 (6.9%)

2 (1.1%)

Postoperative immunomodulators

4 (6.9%)

26 (14.8%)

0.47

Postoperative use of biologics

3 (5.2%)

30 (17%)

0.02

Final pouch condition

0.15

Normal

3 (5.2%)

10 (5.7%)

Irritable pouch syndrome

8 (13.8%)

22 (12.5%)

Active pouchitis

11 (19%)

16 (9.1%)

Refractory pouchitis

11 (19%)

29 (16.5%)

Crohn’s disease

10 (17.2%)

49 (27.8%)

Cuffitis

8 (13.8%)

14 (8%)

Surgical complications

7 (12.1%)

36 (20.5%)

Pouch failure

6 (10.3%)

29 (16.5%)

0.30

**Table 4.** Multivariate Analysis of Risk Factors of Enlarged Prostate
Variable	Odds ratio (95% confidence interval)	P value
Age	1.1 (1.05 - 1.11)	0
Acute pouchitis	2.4 (0.9 - 6.2)	0.07
S-pouch	7.2 (1.1 - 46.4)	0.04
Redo pouch	1.4 (0.6 - 3.4)	0.42

Table 4. Multivariate Analysis of Risk Factors of Enlarged Prostate

Variable

Odds ratio (95% confidence interval)

P value

Age

1.1 (1.05 - 1.11)

Acute pouchitis

2.4 (0.9 - 6.2)

0.07

S-pouch

7.2 (1.1 - 46.4)

0.04

Redo pouch

1.4 (0.6 - 3.4)

0.42