Value of Prostate-Specific Antigen, Total Prostate Volume, Transition Zone Volume and Transition Zone Index as the Predictors of Effective Response for Alpha-blocker (Terazosin) Monotherapy in the Management of Benign Prostate Hyperplasia / 대한비뇨기과학회지

PURPOSE: We investigated the efficacy of various parameters by transrectal ultrasonography (TRUS), and PSA levels, as predictors for the effectiveness of alpha-blocker(terazosin) monotherapy. MATERIALS AND METHODS: We evaluated 126 benign prostatic hyperplasic (BPH) patients, who underwent alpha-blocker (terazosin) monotherapy, according to their International Prostate Symptom Score (IPSS), peak flow rate (Qmax), prostate specific antigen(PSA), total prostate volume (TPV), transition zone volume (TZV) and transition zone index (transition zone volume/total prostate volume, TZI) for prediction the response to alpha-blocker (terazosin) monotherapy in men with symptomatic BPH. The patients were categorized into two groups; the good result, and the poor result groups. RESULTS: Following medication with terazosin, the IPSS decreased and the Qmax was significantly increased in all patients. However, according to the patients' subjective satisfaction of the treatment, those in the good result group (64 patients) had smaller TPV and TZV than those in the poor result group (61 patients). There were no significantly differences in PSA and TZI between the two groups. CONCLUSIONS: Terazosin was effective in reducing the symptoms and the improving peak flow rates in symptomatic BPH patients. TPV and TZV correlated significantly with the evaluated parameters in symptomatic BPH patients who underwent alpha-blocker monotherapy.

A study of prostate volume,prostate weight and the clinical parameters in BPH patients / 中华泌尿外科杂志

Objective To study the prostate volume,prostate weight and the clinical parameters in BPH patients and to investigate the interrelationships between the relevant parameters. Methods The complete data of 80 cases of BPH underwent open surgery were reviewed and analyzed.SPSS software was uesd to make the statistical analysis. Results The volume of surgical specimen has been positively correlated with PV( r=0.872,P

Analysis on the Correlation Between Transition Zone Index and Bladder Outlet Obstruction Caused by Benign Prostate Hyperplasia / 대한비뇨기과학회지

PURPOSE: Prostate volume has been poorly correlated with various parameters used to assess benign prostate hyperplasia (BPH), including symptom score, total prostate volume, peak flow rate and postvoid residual urine. The purpose of this study is to determine if measurement of the volume and the index of transition zone of the prostate correlated well with other clinical parameters in predicting the degree of obstruction. MATERIALS AND METHODS: 121 men with lower urinary tract symptoms were prospectively evaluated using international prostate symptom score, transrectal ultrasonography, and urodynamic investigation with pressure-flow studies for BPH. Bladder outlet obstruction was defined as the maximal detrusor pressure was greater than 40cmH2O at peak flow and peak flow rate was less than 10ml/sec. Patients were then divided into obstructive and non-obstructive groups. Correlations were evaluated among the total prostatic volume (TPV), transition zone volume (TZV), transition zone index (TZI=TZV/TPV) and other clinical and urodynamically obstructive parameters. RESULTS: Age, IPSS, peak flow rate and PVR were not significantly different between obstructive (n=69) and non-obstructive (n=52) groups. Among the transrectal sonographic parameters, TZV and TZI correlated better with urodynamically obstructive parameters such as detrusor pressure at peak flow rate (r=0.551, 0.544), Abrams Griffiths number (r=0.576, 0.506) and linear passive urethral resistance relation (r=0.560, 0.580) than with TPV. There were no correlations between clinical and volume parameters. All the volume parameters of the prostate were larger in obstructive than in non- obstructive group. CONCLUSIONS: In patients with BPH symptoms, TZV and TZI correlates better with urodynamically obstructive parameters than did the total prostate volume. TZV or TZI may serve as more useful method for evaluating obstruction.

Comparison of the Clinical Effects after Finasteride Treatment for Benign Prostatic Hyperplasia according to the Transition Zone Volume and Transition Zone Index / 대한비뇨기과학회지

PURPOSE: Recent studies suggest that the symptomatic improvement in benign prostatic hyperplasia significantly related with transition zone volume (TZV). The purpose of this study was to determine the clinical significance of TZV and transition zone index (TZI) in changes of prostate volume (PV) and clinical parameters following finasteride therapy. MATERIALS AND METHODS: 140 patients over 50 years of age with symptomatic benign prostatic hyperplasia were treated with finasteride (5mg/d) for 12 months and underwent transrectal ultrasound evaluation of PV and TZV prior to initiating therapy and after 12 months. Patients were grouped according to the results of PV (> OR =40ml or OR =0.45 or OR =2.5 or <2.5). The responders was determined as improvement in peak flow rate more than 3mL/sec. RESULTS: PV decreased by 14.11% in patients with TZI less than 0.45, while the decrease was 19.25% for men with TZI greater than 0.45 (p<0.01). In addition, PV was significantly decreased by 16.72% in patients with PV less than 40cc and TZI greater than 0.45 (p<0.01). PV decreased by 17.37% in patients with PSA less than 2.5, while the decrease was 18.92% in men with PSA greater than 2.5. In responders, only TZI was significantly different among PSA, PV and TZI (p<0.05). CONCLUSIONS: Treatment effect of finasteride on symptomatic benign prostatic hyperplasia patients was increased in proportion to enlarged PV, increased TZI, increased PSA. TZI was a useful proxy for predicting clinical outcomes in initiating finasteride therapy on benign prostatic hyperplasia.

A Study of Correlations among International Prostate Symptom Score (IPSS), Volume of Total and Transition Zone of Prostate Measured by Transrectal Ultrasonography, Serum PSA Level in Benign Prostatic Hyperplasia / 대한비뇨기과학회지

This study was aimed to investigate the possible correlations between International Prostate Symptom Score (IPSS), volume of total and transition zone of prostate, and serum prostate specific antigen (PSA) level in 42 patients diagnosed and treated as benign prostatic hyperplasia. We got IPSS by interview and calculated the volume of the total and the transition zone (TZ vol) of prostate by transrectal ultrasonography. The size of the total prostate was 37.35+/-12.9 cc (mean+/-standard deviation) and that of the transition zone was 17.72 +/- 10.04 cc. Transition zone index(transition zone volume/total prostate volume, TZ index) was calculated and its value was 0.45 +/- 0.14. Symptom score was not correlated with total prostate volume, TZ volume or 72 index (r=0.27, p>0.05; r=0.23, p>0.05; r=0.16, p>0.05, respectively). Either it did not show correlation with serum PSA level (r=0.16, p>0.05). However, there were statistically significant correlations among serum PSA, total volume, TZ volume, TZ index (r=0.66, p<0.05; r=0.64, p<0.05; r=0.47, p<0.05). From these results, it is difficult to find significant correlations between symptom severity easured by IPSS and several clinical indices such as total prostate volume, transitional volume, TZ index or serum PSA level. Prospective study including developing a more objective symptom scoring system is needed to get a more useful clinical index reflecting the symptom severity of the BPH patients as well as clinical status of them.