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

The Correlation between Residual Prostatic Volume Ratio and Parameters of Prostate Volume and Clinical Parameters before and after Transurethral Resection of Prostate in BPH

PURPOSE: Prostate volume(PV) has been known to be poorly correlated with other clinical parameters used to assess benign prostate hyperplasia (BPH), including international prostate symptom score(IPSS), peak flow rate(Qmax) and amount of postvoid residuals(PVR). The purpose of this study was to determine if the parameters of prostate volume including PV, transition volume, transitional zone index (TZI) and residual prostatic volume ratio(RPVR) correlated well with other clinical parameters before and after transurethral resection of prostate(TURP). MATERIALS AND METHODS: 31 men with symptomatic BPH were evaluated using IPSS, Qmax before and after TURP and the parameters of prostate volume were determined by transrectal ultrasonography(TRUS). The clinical outcome was evaluated by the difference(Delta) in IPSS, Qmean and Qmax before and 3 months after TURP. RESULTS: PV was not correlated with DeltaIPSS and DeltaQmax, but transition volume(r=0.394, p=0.034) and TZI(r=0.368, p=0.049) were significantly correlated with DeltaQmax. There were negative correlations between the RPVR and DeltaIPSS and DeltaQmax(r=-0.449, -0.385, p=0.011, 0.033). CONCLUSIONS: TRUS is a useful tool for estimating prostate weight before surgery of BPH. Transition volume, TZI and RPVR could be useful parameters to predict the IPSS and Qmax after TURP based with IPSS and Qmax before TURP. The smaller the RPVR after TURP, the better the clinical outcome.

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.

The Correlation between Transition Zone Index, versus IPSS and Peak Flow Rate after Transurethral Resection of Prostate in Benign Prostatic Hyperplasia / 대한비뇨기과학회지

PURPOSE: There is debate whether transition zone index is correlated with the parameters of benign prostatic hyperplasia. The purpose of this study was 3-fold: 1) to determine if transition zone index is correlated with the symptom score and peak flow rates of clinical benign prostatic hyperplasia, 2) to determine if transition zone index is correlated with the symptom score and peak flow rates of clinical benign prostatic hyperplasia after TURP, and lastly 3) to determine if the improvement of symptom score and peak flow rates after TURP is different according to transition zone index. MATERIALS AND METHODS: Fifty eight men, who underwent TURP, were measured total prostate volume and transition zone volume by trasnsrectal ultrasonography. All men were requested to undergo uroflowmetry and intermational prostate symptom score(IPSS), before and after TURP. RESULTS: The significant correlation between transition zone index and IPSS(p = 0.0001, R2 = 0.3652), and the relationships between transition zone index versus peak flow were not statistically significant(p = 0.79, R2 = 0.0015) before TURP. A weak relationship was observed between transition zone index versus IPSS(p = 0.0019, R2 = 0.16), peak flow rate(p = 0.022, R2 = 0.0811) after TURP. The improvement of IPSS and peak flow rate showed statistically significant difference according to transition zone index(p = 0.0001, 0.0787) CONCLUSIONS: The higher transition zone index, the more favorable outcome of transurethral resection of prostate was expected. On the contrary, the lower transition zone index, the less favorable outcome. So transition zone index can be used as a factor predicting the outcome of transurethral resection of prostate. The patient with lower transition zone index may have other factors affecting improvement of symptoms and peak flow rate in addition to obstruction.

Usefulness of Transition Zone Index in Assessing Benign Prostatic Hyperplasia: Correlation with Symptom Score and Uroflow / 대한비뇨기과학회지

PURPOSE: Prostate volume has been known to be poorly correlated with other parameters used to assess benign prostatic hyperplasia(BPH), including symptom score, peak flow rate(Qmax), amount of postvoid residuals(PVR). The purpose of this study was to determine if measurement of the transition zone index(TZI) of the prostate correlated well with other clinical parameters in predicting the degrees of obstruction. MATERIALS AND METHOD: We prospectively evaluated 86 men with symptomatic BPH(mean age: 65.4 years) according to symptoms, Qmax, PVR, transrectal ultrasound volume of the entire prostate and the transition zone. TZI was determined as the ratio between transition zone volume(TZV) and total prostate 1 volume(TV). RESULTS: Age correlated with symptoms(r=0.29, p=0.006) and PVR(r=0.466, p=0.001); Qmax negatively correlated with age(r=-0.487, p=0.001), symptoms 1 (r=-0.28, p=0.007) and PVR(r=-0.36, p=0.001). Age also correlated with TV(r=0.4, p=0.001), TZV(r=0.435, p=0.001) and, TZI(r=0.36, p=0.001). There was a weak correlations between TV and symptom r=0.23), Qmax(r=0.28), and PVR(r=0.24); a stronger correlation were noted between TZ and symptoms(r=0.33), Qmax(r=-0.35) or PVR(r=0.28). There were significant correlation between TZI and symptoms(r=0.35), Qmax(r=-0.38) or PVR(r=0.30). Age, PVR, 721, and TZV were significantly greater and Qmax were significantly lower in severe (IPSS > or = 20, N=38) symptom group than in moderate(IPSS or = 15m1/sec) group. No significant differences of TV were noted either between moderate and severe symptom group or low and high Qmax group. CONCLUSIONS: Transition zone volume or index are parameters that correlates significantly with evaluated parameters of BPH and may serve as a useful method for evaluating obstruction. Studies are underway to determine if transition zone index can be used prospectively to predict and correlate response with therapies designed to ablate prostatic tissue medically or surgically.