Ultrasound derived-parameters and symptom severity scores as noninvasive predictors of bladder outlet obstruction in patients with benign prostatic enlargem

Introduction: Benign prostatic hyperplasia (BPH) is common in men over 50 years and causes lower urinary tract (LUT) symptoms. There is an emerging need to explore the value of utilizing ultrasound (US)-derived parameters of the LUT as noninvasive predictors of the degree of bladder outlet obstruction (BOO) from BPH and determine if they correlate with the symptom severity observed in these patients. This study aimed to determine the utility of US-derived parameters of the LUT (prostate volume [PV], bladder wall thickness [BWT], and postvoid residual volume [PVR]) in predicting severity of BOO and correlating them with the symptom severity scores ­ International Prostate Symptom Score (IPSS) and quality of life (QoL) ­ in patients with BPH in our practice.Methodology: We prospectively studied 100 newly diagnosed patients with symptomatic BPH who presented to the urology outpatient clinic and were referred to the radiology department for transabdominal scan of the urinary bladder and prostate. The patients' age, IPSS, and QoL and their BWT1 (full bladder), BWT2 (empty bladder), PV, and PVR were measured using transabdominal US scan. Correlation was done using Pearson's correlation coefficient, and P < 0.05 was considered statistically significant.Results: The mean age of the participants was 60 years. The mean BTW1 and BTW2 were 4.66 mm and 25.80 mm, respectively. The mean IPSS was 16, with a majority (42%) having severe symptoms. There is a negative insignificant correlation between PVR and BTW2 (r = −0.053, P = 0.603). There is a weak but statistically insignificant correlation between QoL and BWT. There is a weak but insignificant correlation between PV and IPSS (r = 0.193, P = 0.055). There is a weak but insignificant correlation between IPSS and BWT. There is a moderate and statistically significant correlation between IPSS and PVR (r = 0.350, P < 0.001).Conclusion: In our patients, we found that BWT had an insignificant correlation with QoL and a negative correlation with PVR, respectively. We could show, however, that in them, PVR and IPSS were significantly correlated

Accuracy of digital rectal examination to diagnose prostate cancer confirmed by needle biopsy reports: A 3­year hospital-based study

Background: Digital rectal examination (DRE) is an indispensable tool for provisional diagnosis of prostate diseases. When abnormal prostate examination findings are elicited, a diagnosis of prostate cancer (Pca) is usually entertained and further tests to confirm or rule out the presence of Pca demands histological examination of biopsied tissue. A combination of DRE findings and serum PSA increases the predictive value for Pca diagnosis. In this study, we evaluated the degree of accuracy of DRE to diagnose Pca confirmed by histology reports of biopsy specimens.Materials and Methods: Two hundred and six (206) patients were studied over a period of three years. Information retrieved from their case notes were entered into a well-structured protocol for management of prostatic diseases. Analysis of variables collated was performed with the statistical package for the social sciences (SPSS) version 20.0. Frequency table was used to analyze categorical variables while descriptive statistics was used for continuous variables. Level of significance was set at P<.05.Results: 206 patients were studied with mean age of 68.23±8.71 years ranging from 48 to 91 years. Men in the Pca group were older than those in the BPH group. Abnormal DRE was associated with high grade tumours, and high level of aggressive tumour characteristics by WHO grade group standard.Conclusion: DRE has a high level of accuracy in predicting a diagnosis of Pca which was confirmed by histology reports especially in prostates with abnormal findings

Prevalence and Determinants of Lower Urinary Tract Symptoms before and during Pregnancy in a Cohort of Nigerian Women

Background: Pregnancy and childbirth are thought to be associated with development of lower urinary tract symptoms (LUTS). The study aimed at ascertaining prevalence rates of LUTS before and during pregnancy; the determinants and perceived effects of these symptoms on the life of the women. Materials and Methods: Questionnaires in which LUTS were defined according to recommendations of International Continence Society was administered on consecutive women who delivered at ?37 weeks' gestation to ascertain the presence or absence of LUTS before and during pregnancy and perceived effects on their life. Data was also collected on their socio-demographic and obstetric features. Descriptive statistics and relationship between LUTS and other variables were analyzed using SPSS version 16. Results: Prevalence rates of LUTS before and during pregnancy were 52.9 and 89.2; respectively; and mostly included nocturia and stress urinary incontinence. Women were more likely to develop LUTS during pregnancy (P = 0.002; OR 4.99; 95 CI 1.793 - 13.906). Only 14.4 and 41.7 reported any burden on their daily life before and during pregnancy; respectively. Previous vaginal delivery (P = 0.01; OR 3.12; 95 CI 2.91-5.62); grand-multiparity (P = 0.04; OR 4.15; 95 CI 3.82-7.24) were associated with LUTS prior to pregnancy while presence of LUTS before pregnancy (P = 0.001; OR 10.80; 95 CI 4.24-27.52); previous vaginal delivery (P = 0.002; OR 6.38; 95 CI 4.25-12.43) and moderate maternal obesity (P = 0.03; OR 2.56; 95 CI 1.82-3.47) were predictive of LUTS during pregnancy. Conclusion: LUTS are common among women both before and during pregnancy but most of them were not bothered by the LUTS. Those with previous vaginal delivery and are grand-multiparous are more likely to develop LUTS prior to pregnancy while the presence of LUTS before pregnancy; vaginal delivery and maternal obesity are determinants of LUTS during pregnancy

La symptomatologie du bas appareil urinaire de l'homme a l'Hopital Central de Yaounde. a propos de 329 cas

OBJECTIFS : La symptomatologie du bas appareil urinaire [SBAU] a fait l'objet de nombreuses etudes dans beaucoup de pays mais tres peu dans notre milieu. Le but de cette etude etait d'evaluer la prevalence de la SBAU dans notre milieu ainsi que la pathologie tumorale prostatique associee. MeTHODES : Il s'agit d'une etude transversale realisee a l'occasion d'une campagne de depistage volontaire des tumeurs prostatiques. Les parametres etudies etaient l'age des patients; le statut professionnel; le score IPSS; le score de gene; le resultat du toucher rectal et le celui des dosages de PSA. etait considere porteur d'une HBP symptomatique tout patient avec un score IPSS superieur a 8; un score de gene superieur ou egal a 3 et une HBP au toucher rectal. Tous les patients avec un toucher rectal suspect et ou des PSA eleves beneficiaient d'une biopsie prostatique. Nous avons enfin note la prise en charge.ReSULTATS : Nous avions recrute 329 patients ages de 45 a 79 ans [moyenne 56 ans]. La moyenne d'age des patients porteurs d'une hypertrophie benigne de la prostate etait de 61.6 ans. 181 patients [56.9] avaient un score IPSS jugee moderee a severe; 200 patients [60;8] avaient un score de gene superieur a 3. Il y avait une correlation entre l'IPSS et l'age; l'IPSS et le score de gene. 184 patients etaient porteurs d'une HBP dont 118 avaient une HBP symptomatique parmi lesquels 17 avaient ete operes; 66 avaient eu un traitement medical et 35 avaient ete perdus de vue. 10 patients avaient un cancer de la prostate. CONCLUSION : La SBAU de l'homme est frequente dans notre milieu. Elle survient dans une population plus jeune que celle decrite dans la litterature. Peu de patients en parlent a leur Medecin malgre les risques de complications pouvant grever le pronostic vital. Il est par consequent important d'informer les patients et de sensibiliser les medecins sur la SBAU et les pathologies associees