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Minagawa T. Recent developments in diagnostic ultrasound for lower urinary tract function. J Med Ultrason (2001) 2024:10.1007/s10396-024-01494-0. [PMID: 39327335 DOI: 10.1007/s10396-024-01494-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2024] [Accepted: 08/05/2024] [Indexed: 09/28/2024]
Abstract
Ultrasonography (US) is an essential tool in the clinical management of lower urinary tract dysfunction (LUTD), including lower urinary tract symptoms, overactive bladder, and benign prostatic hyperplasia, in which prostatic volume and post-void residual volume are routinely used to evaluate the pathophysiological characteristics of afflicted patients. US can also be employed to diagnose hydronephrosis and bladder calculus as complications of severe LUTD. Moreover, US is essential for identifying pathophysiological characteristics and surgical indications, predicting disease development and drug efficacy, and monitoring bladder function improvement by means of such parameters as bladder wall thickness, prostatic urethral length, intravesical prostatic protrusion, and prostatic urethral angulation/angle. Herein, I narratively review the recent advances in US approaches for the management of LUTD, especially in adult males.
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Affiliation(s)
- Tomonori Minagawa
- Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, 390-8621, Japan.
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Gharbieh S, Reeves F, Challacombe B. The prostatic middle lobe: clinical significance, presentation and management. Nat Rev Urol 2023; 20:645-653. [PMID: 37188789 DOI: 10.1038/s41585-023-00774-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/14/2023] [Indexed: 05/17/2023]
Abstract
The role of the prostatic middle lobe in the presentation and management of benign prostatic hyperplasia (BPH) is under-appreciated. Middle lobe enlargement is associated with intravesical prostatic protrusion (IPP), which causes a unique type of bladder outlet obstruction (BOO) via a 'ball-valve' mechanism. IPP is a reliable predictor of BOO and the strongest independent factor for failure of medical therapy necessitating conversion to surgical intervention. Men with middle lobe enlargement tend to exhibit mixed symptoms of both the storage and the voiding types, but symptomatology will vary depending on the degree of IPP present. Initial assessments such as uroflowmetry and post-void residual volumes are inadequate to detect IPP and could confound the clinical picture. Radiological evaluation of prostate morphology is key to assessment as it provides important prognostic information and can help with operative planning. Treatment strategies employed for BPH should consider the shape and morphology of prostate adenomata, specifically the presence of middle lobe enlargement and the degree of associated IPP.
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Abotsi E, Adanu KK, Bansah EC. Serum prostate specific antigen is a good indicator of prostatic volume in men with benign prostatic hyperplasia. Afr J Prim Health Care Fam Med 2022; 14:e1-e6. [PMID: 36546488 PMCID: PMC9772733 DOI: 10.4102/phcfm.v14i1.3736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 09/07/2022] [Accepted: 09/07/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Benign prostatic hyperplasia (BPH) is the most common cause of bladder outlet obstruction in men over the age of 50 years. An association between the prostate specific antigen (PSA), International Prostate Symptoms Score (IPSS) and prostate volume (PV) may be instrumental in determining patients who may benefit from treatment. Targeted therapy will reduce the cost of care because it is unwise to treat all men with prostate enlargement to prevent complications when the risk of occurrence is negligible. AIM To determine the correlation between the PSA, IPSS and PV in men of African descent. SETTING This was a cross sectional analysis involving 92 patients diagnosed as having symptomatic BPH at the Ho Teaching Hospital. METHODS The data were collected using standardised questionnaires. The IPSS determined urinary symptom severity. The PV was determined using a transabdominal ultrasound machine. Serum PSA was retrieved from the electronic medical records. RESULTS The mean PV was 61.04 cm3 ± 21.95 cm3, the mean PSA was 4.21 ng/mL ± 3.85 ng/mL, and mean IPSS of 21.59 ± 3.78. The Pearson's correlation between PV and PSA was 0.283 (p = 0.01), between PV and IPSS was 0.108 (p = 0.30), and finally, between Serum PSA and IPSS Score was -0.086 (p = 0.42). CONCLUSION This study showed that serum PSA has a positive correlation with PV. However, IPSS had no significant association with PSA or PV in patients with BPH.Contribution: This study provides insights into the implications of clinical parameters on the management of prostate enlargement.
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Affiliation(s)
- Ebenezer Abotsi
- Department of Obstetrics and Gynaecology, Ho Teaching Hospital, Ho.
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Vredeveld T, van Benten E, Beekmans REPM, Koops MP, Ket JCF, Mollema J, Ramaekers SPJ, Pool JJM, Coppieters MW, Pool-Goudzwaard AL. Reliability and validity of assessment methods available in primary care for bladder outlet obstruction and benign prostatic obstruction in men with lower urinary tract symptoms: a systematic review. BMJ Open 2022; 12:e056234. [PMID: 35487713 PMCID: PMC9058800 DOI: 10.1136/bmjopen-2021-056234] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES To systematically review the literature regarding the reliability and validity of assessment methods available in primary care for bladder outlet obstruction or benign prostatic obstruction in men with lower urinary tract symptoms (LUTS). DESIGN Systematic review with best evidence synthesis. SETTING Primary care. PARTICIPANTS Men with LUTS due to bladder outlet obstruction or benign prostatic obstruction. REVIEW METHODS PubMed, Ebsco/CINAHL and Embase databases were searched for studies on the validity and reliability of assessment methods for bladder outlet obstruction and benign prostatic obstruction in primary care. Methodological quality was assessed with the COSMIN checklist. Studies with poor methodology were excluded from the best evidence synthesis. RESULTS Of the 5644 studies identified, 61 were scored with the COSMIN checklist, 37 studies were included in the best evidence synthesis, 18 evaluated bladder outlet obstruction and 17 benign prostatic obstruction, 2 evaluated both. Overall, reliability was poorly evaluated. Transrectal and transabdominal ultrasound showed moderate to good validity to evaluate bladder outlet obstruction. Measured prostate volume with these ultrasound methods, to identify benign prostatic obstruction, showed moderate to good accuracy, supported by a moderate to high level of evidence. Uroflowmetry for bladder outlet obstruction showed poor to moderate diagnostic accuracy, depending on used cut-off values. Questionnaires were supported by high-quality evidence, although correlations and diagnostic accuracy were poor to moderate compared with criterion tests. Other methods were supported by low level evidence. CONCLUSION Clinicians in primary care can incorporate transabdominal and transrectal ultrasound or uroflowmetry in the evaluation of men with LUTS but should not solely rely on these methods as the diagnostic accuracy is insufficient and reliability remains insufficiently researched. Low-to-moderate levels of evidence for most assessment methods were due to methodological shortcomings and inconsistency in the studies. This highlights the need for better study designs in this domain.
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Affiliation(s)
- Tom Vredeveld
- Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Centre of Expertise Urban Vitality, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
| | - Esther van Benten
- Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- HU University of Applied Sciences Utrecht, Institute of Movement Sciences, Utrecht, The Netherlands
| | | | - M Patrick Koops
- Physiotherapy Practice De Werfheegde, Haaksbergen, The Netherlands
| | - Johannes C F Ket
- Medical Library, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Jurgen Mollema
- Medical Library, HU University of Applied Sciences Utrecht, Utrecht, The Netherlands
| | - Stephan P J Ramaekers
- Centre of Expertise Urban Vitality, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
| | - Jan J M Pool
- HU University of Applied Sciences Utrecht, Institute of Movement Sciences, Utrecht, The Netherlands
| | - Michel W Coppieters
- Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Menzies Health Institute Queensland, Griffith University, Brisbane and Gold Coast, Queensland, Australia
| | - Annelies L Pool-Goudzwaard
- Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- SOMT University of Physiotherapy, Amersfoort, The Netherlands
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David RA, Badmus TA, Salako AA, Asaleye CM, Adeloye D, Fanimi O, Opele JK, Laoye A, Akinbola IA, Igbokwe MC, Babalola RN, Onyeze CI. Diagnostic performance of transrectal ultrasound for prostate volume estimation in men with benign prostate hyperplasia. Int J Clin Pract 2020; 74:e13615. [PMID: 32683766 DOI: 10.1111/ijcp.13615] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 07/08/2020] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND AND AIM Despite transrectal ultrasound (TRUS) being regarded as gold standard for prostate volume estimation, concerns have been raised in the literature concerning its accuracy especially in men with above-average prostate volumes. We aimed to evaluate the performance of TRUS for prostate volume estimation in a cohort of sub-Saharan African men since they are known to have relatively large mean prostate volumes. METHODS This was a prospective study of 77 sub-Saharan African men who had open simple prostatectomy for benign prostate hyperplasia (BPH). Pre-operative TRUS determined total prostate volume (TPV) and transition zone volume (TZV). Following surgical enucleation, the adenoma was weighed (EPW) and its volume (EPV) also determined by fluid displacement. TRUS was repeated six weeks post-operatively to calculate the TRUS-estimated specimen volume (TESV). RESULTS The mean EPV, EPW, TRUS-estimated TZV, TRUS-estimated TPV and TESV were 79.1 ± 62.9 ml, 79.1 ± 62.9 g, 53.3 ± 28.5 ml, 93.1 ± 48.9 ml and 69.9 ± 44.6 ml, respectively. Pearson's correlation showed a perfect relationship between EPW and EPV with no difference in their mean values (r = 1.000; P < .001). Pearson's correlation between TRUS-estimated TPV vs EPV, TRUS-estimated TZV vs EPV, and between TESV vs EPV were 0.932, 0.865 and 0.930, respectively (P = .0000). TRUS significantly under-estimated the TZV and TESV by 25.8 ml and 9.2 ml, respectively; unrelated to the severity of prostate enlargement. CONCLUSION TRUS underestimates prostate volume, independent of prostate size. We propose simple formulae that could be used to improve the prostate volume determination from TRUS, especially if magnetic resonance imaging is not readily available or contraindicated.
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Affiliation(s)
- Rotimi A David
- Urology Unit, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria
| | - Tajudeen A Badmus
- Urology Unit, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria
| | - Abdulkadir A Salako
- Urology Unit, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria
| | - Christianah M Asaleye
- Radiology Department, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria
| | - Davies Adeloye
- Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Olubukola Fanimi
- Radiology Department, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria
| | - Jacob K Opele
- National Centre for Technology Management, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Adeyinka Laoye
- Urology Unit, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria
| | - Ibrahim A Akinbola
- Urology Unit, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria
| | - Martin C Igbokwe
- Urology Unit, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria
| | - Rereloluwa N Babalola
- Urology Unit, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria
| | - Chigozie I Onyeze
- Urology Unit, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria
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Alexander LF, Oto A, Allen BC, Akin O, Chong J, Froemming AT, Fulgham PF, Goldfarb S, Maranchie JK, Mody RN, Patel BN, Schieda N, Schuster DM, Turkbey IB, Venkatesan AM, Wang CL, Lockhart ME. ACR Appropriateness Criteria® Lower Urinary Tract Symptoms-Suspicion of Benign Prostatic Hyperplasia. J Am Coll Radiol 2019; 16:S378-S383. [DOI: 10.1016/j.jacr.2019.05.031] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 05/16/2019] [Indexed: 01/31/2023]
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Gandhi J, Weissbart SJ, Kim AN, Joshi G, Kaplan SA, Khan SA. Clinical Considerations for Intravesical Prostatic Protrusion in the Evaluation and Management of Bladder Outlet Obstruction Secondary to Benign Prostatic Hyperplasia. Curr Urol 2018; 12:6-12. [PMID: 30374274 DOI: 10.1159/000447224] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Accepted: 11/28/2017] [Indexed: 01/23/2023] Open
Abstract
Background Intravesical prostatic protrusion (IPP) is a manifestation of benign prostatic hyperplasia marked by overgrowth of the prostatic median lobe into the bladder, producing bladder outlet obstruction and related storage and voiding symptoms. Methods A MEDLINE® database search of the current literature was guided using combination of "prostate" with the following terms: intravesical prostatic protrusion, bladder trabeculation, bladder outlet obstruction, lower urinary tract symptoms, alpha blockers, transrectal ultrasonography, and prostatectomy. Results Although IPP can be identified via a variety of imaging modalities, it is easily detected via transrectal ultrasonography (TRUS). Failing to detect IPP promptly by TRUS may result in refractory symptoms of benign prostatic hyperplasia, as the condition may not respond to typical α1-adrenoceptor antagonist therapy. In addition, depending on grade, IPP can influence outcomes and complications of prostatectomies. Conclusion Upon report of lower urinary tract symptoms, initial performance of TRUS along with digital rectal examination prevents delay in the appropriate evaluation and management of prostatic diseases.
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Affiliation(s)
- Jason Gandhi
- Department of Physiology and Biophysics, Stony Brook University Medicine, Stony Brook, Southampton, New York.,Department of Medical Student Research Institute, St. George's University School of Medicine, St. George, Grenada
| | - Steven J Weissbart
- Department of Urology, Stony Brook University Medicine, Stony Brook, Southampton, New York
| | - Albert N Kim
- Department of Urology, Stony Brook University Medicine, Stony Brook, Southampton, New York
| | - Gunjan Joshi
- Department of Internal Medicine, Stony Brook Southampton Hospital, Southampton, New York
| | - Steven A Kaplan
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York.,Department of Men's Wellness Program, Mount Sinai Health System, New York, NY, USA
| | - Sardar Ali Khan
- Department of Physiology and Biophysics, Stony Brook University Medicine, Stony Brook, Southampton, New York.,Department of Urology, Stony Brook University Medicine, Stony Brook, Southampton, New York
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Heidler S, Drerup M, Lusuardi L, Bannert U, Bretterbauer K, Bures J, Dietersdorfer F, Dlouhy-Schütz E, Hessler C, Karpf R, Mittellehner LA, Mitlöhner B, Schwarz S, Thomay G, Lösch G, Freibauer C, Albrecht W. The Correlation of Prostate Volume and Prostate-specific Antigen Levels With Positive Bacterial Prostate Tissue Cultures. Urology 2018. [DOI: 10.1016/j.urology.2018.02.035] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Chughtai B, Forde JC, Thomas DDM, Laor L, Hossack T, Woo HH, Te AE, Kaplan SA. Benign prostatic hyperplasia. Nat Rev Dis Primers 2016; 2:16031. [PMID: 27147135 DOI: 10.1038/nrdp.2016.31] [Citation(s) in RCA: 203] [Impact Index Per Article: 25.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Benign prostatic hyperplasia (BPH), which causes lower urinary tract symptoms (LUTS), is a common diagnosis among the ageing male population with increasing prevalence. Many risks factors, both modifiable and non-modifiable, can increase the risk of development and progression of BPH and LUTS. The symptoms can be obstructive (resulting in urinary hesitancy, weak stream, straining or prolonged voiding) or irritative (resulting in increased urinary frequency and urgency, nocturia, urge incontinence and reduced voiding volumes), or can affect the patient after micturition (for example, postvoid dribble or incomplete emptying). BPH occurs when both stromal and epithelial cells of the prostate in the transitional zone proliferate by processes that are thought to be influenced by inflammation and sex hormones, causing prostate enlargement. Patients with LUTS undergo several key diagnostic investigations before being diagnosed with BPH. Treatment options for men with BPH start at watchful waiting and progress through medical to surgical interventions. For the majority of patients, the starting point on the treatment pathway will be dictated by their symptoms and degree of bother.
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Affiliation(s)
- Bilal Chughtai
- Department of Urology, Weill Cornell Medical College-New York Presbyterian Hospital, New York, New York, USA
| | - James C Forde
- Department of Urology, Weill Cornell Medical College-New York Presbyterian Hospital, New York, New York, USA
| | - Dominique Dana Marie Thomas
- Department of Urology, Weill Cornell Medical College-New York Presbyterian Hospital, New York, New York, USA
| | - Leanna Laor
- Department of Urology, Weill Cornell Medical College-New York Presbyterian Hospital, New York, New York, USA
| | - Tania Hossack
- Department of Urology, Sydney Adventist Hospital Clinical School, University of Sydney, Sydney, New South Wales, Australia
| | - Henry H Woo
- Department of Urology, Sydney Adventist Hospital Clinical School, University of Sydney, Sydney, New South Wales, Australia
| | - Alexis E Te
- Department of Urology, Weill Cornell Medical College-New York Presbyterian Hospital, New York, New York, USA
| | - Steven A Kaplan
- Department of Urology, Icahn School of Medicine at Mount Sinai, Mount Sinai Health System, 625 Madison Avenue, New York, New York 10022, USA
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Gratzke C, Bachmann A, Descazeaud A, Drake MJ, Madersbacher S, Mamoulakis C, Oelke M, Tikkinen KAO, Gravas S. EAU Guidelines on the Assessment of Non-neurogenic Male Lower Urinary Tract Symptoms including Benign Prostatic Obstruction. Eur Urol 2015; 67:1099-1109. [PMID: 25613154 DOI: 10.1016/j.eururo.2014.12.038] [Citation(s) in RCA: 608] [Impact Index Per Article: 67.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Accepted: 12/26/2014] [Indexed: 11/25/2022]
Abstract
CONTEXT Lower urinary tract symptoms (LUTS) represent one of the most common clinical complaints in adult men and have multifactorial aetiology. OBJECTIVE To develop European Association of Urology (EAU) guidelines on the assessment of men with non-neurogenic LUTS. EVIDENCE ACQUISITION A structured literature search on the assessment of non-neurogenic male LUTS was conducted. Articles with the highest available level of evidence were selected. The Delphi technique consensus approach was used to develop the recommendations. EVIDENCE SYNTHESIS As a routine part of the initial assessment of male LUTS, a medical history must be taken, a validated symptom score questionnaire with quality-of-life question(s) should be completed, a physical examination including digital rectal examination should be performed, urinalysis must be ordered, post-void residual urine (PVR) should be measured, and uroflowmetry may be performed. Micturition frequency-volume charts or bladder diaries should be used to assess male LUTS with a prominent storage component or nocturia. Prostate-specific antigen (PSA) should be measured only if a diagnosis of prostate cancer will change the management or if PSA can assist in decision-making for patients at risk of symptom progression and complications. Renal function must be assessed if renal impairment is suspected from the history and clinical examination, if the patient has hydronephrosis, or when considering surgical treatment for male LUTS. Uroflowmetry should be performed before any treatment. Imaging of the upper urinary tract in men with LUTS should be performed in patients with large PVR, haematuria, or a history of urolithiasis. Imaging of the prostate should be performed if this assists in choosing the appropriate drug and when considering surgical treatment. Urethrocystoscopy should only be performed in men with LUTS to exclude suspected bladder or urethral pathology and/or before minimally invasive/surgical therapies if the findings may change treatment. Pressure-flow studies should be performed only in individual patients for specific indications before surgery or when evaluation of the pathophysiology underlying LUTS is warranted. CONCLUSIONS These guidelines provide evidence-based practical guidance for assessment of non-neurogenic male LUTS. An extended version is available online (www.uroweb.org/guidelines). PATIENT SUMMARY This article presents a short version of European Association of Urology guidelines for non-neurogenic male lower urinary tract symptoms (LUTS). The recommended tests should be able to distinguish between uncomplicated male LUTS and possible differential diagnoses and to evaluate baseline parameters for treatment. The guidelines also define the clinical profile of patients to provide the best evidence-based care. An algorithm was developed to guide physicians in using appropriate diagnostic tests.
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Affiliation(s)
- Christian Gratzke
- Department of Urology, Urologische Klinik und Poliklinik, Klinikum der Universität München-Grosshadern, Munich, Germany
| | | | - Aurelien Descazeaud
- Department of Urology, Dupuytren Hospital, University of Limoges, Limoges, France
| | - Marcus J Drake
- Bristol Urological Institute and School of Clinical Sciences, University of Bristol, Bristol, UK
| | | | - Charalampos Mamoulakis
- Department of Urology, University General Hospital of Heraklion, University of Crete Medical School, Heraklion, Crete, Greece
| | - Matthias Oelke
- Department of Urology, Hannover Medical School, Hannover, Germany
| | - Kari A O Tikkinen
- Departments of Urology and Public Health, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
| | - Stavros Gravas
- Department of Urology, University of Thessaly, Larissa, Greece.
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Ajayi I, Aremu A, Olajide A, Bello T, Olajide F, Adetiloye V. Correlation of transrectal and transabodominal ultrasound measurement of transition zone volume with post-operative enucleated adenoma volume in benign prostatic hypertrophy. Pan Afr Med J 2013; 16:149. [PMID: 24876907 PMCID: PMC4031091 DOI: 10.11604/pamj.2013.16.149.2532] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2013] [Accepted: 10/03/2013] [Indexed: 11/11/2022] Open
Abstract
Introduction Benign prostatic hyperplasia is a common disease of ageing men worldwide. Though transrectal ultrasonography (TRUS) is the standard in most parts of the world in evaluation of benign prostatic hyperplasia (BPH), it is rarely done in some less developed countries because of non availability of appropriate probes and or specialists. Transabdominal ultrasonography (TAUS) remains the mainstay in these areas. Some controversies still exist in literature about the accuracy of TAUS evaluation of prostatic volume in patients with BPH. This study aimed at comparing the transition zone volume estimation of the prostate on transrectal and transabdominal ultrasound with post-operative enucleated adenoma volume in Nigeria patients with BPH and to suggest better predictor of prostate volume in evaluation of BPH. Methods Forty-six (46) patients with lower urinary tract symptoms due to BPH attending the urologic clinic were evaluated ultrasonographically and eventually managed with open surgery (prostatectomy) after due counselling. The post operative samples were weighted using a sensitive top loading weighing balance and converted to volume. Since the specific gravity of the prostate is equivalent to that of water,the weight is the same as volume. Results Patients’ ages ranged between 59 and 90 years with a peak age incidence at seventh decade. Transition Zone (TZ) volume estimation on both transrectal and transabdominal ultrasound showed positive correlation with the post operative enucleated adenoma(r = 0.594, p < 0.001) but the transrectal method was more accurate. There was no significant relationship between the TZ volume and patients’ symptoms(r = 0.491, p = 0.007). Conclusion Both TRUS and TAUS are comparable at TZ volume estimation and therefore TAUS can be utilized in regions where intracavitary probes and or the expertise is/are not available.
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Affiliation(s)
- Idowu Ajayi
- Radiology Department, Federal Medical Centre, Ido-Ekiti, Ekiti State, Nigeria
| | - Ademola Aremu
- Radiology Department, Ladoke Akintola University Of Technology, Ogbomoso, Oyo State, Nigeria
| | - Abimbola Olajide
- Urology Department, Ladoke Akintola University Of Technology, Ogbomoso, Oyo State, Nigeria
| | - Tope Bello
- Radiology Department, Ladoke Akintola University Of Technology, Ogbomoso, Oyo State, Nigeria
| | - Folake Olajide
- Community Health Department, Obafemi Awolowo, University, Ile-Ife, Osun State, Nigeria
| | - Victor Adetiloye
- Radiology Department, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria
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