Clinical significance of distally located periurethral calcification in patients with lower urinary tract symptoms of benign prostate hyperplasia / 亚洲男科学杂志(英文版)

This study evaluated the association of periurethral calcification (PUC) with uroflowmetric parameters and symptom severity in male patients with lower urinary tract symptoms (LUTS) of benign prostatic hyperplasia (BPH). The data were collected from a prospectively maintained database of 1321 men with LUTS of BPH who visited Chonnam National University Hospital (Gwang-ju, Korea) from January 2015 to December 2019. PUC severity and location were evaluated on the midsagittal plane during transrectal ultrasonography. Relationships among age, prostate-related parameters, International Prostate Symptom Score (IPSS), and uroflowmetric parameters were assessed. Among the 1321 patients in this study, 530 (40.1%) had PUC. Patients with PUC had significantly higher IPSS (mean ± standard deviation [s.d.]: 15.1 ± 8.7 vs 13.1 ± 7.9; P < 0.001) and lower peak flow rate (Qmax; mean ± s.d.: 12.4 ± 6.6 ml s-1 vs 14.7 ± 13.3 ml s-1; P < 0.001), compared with patients who did not have PUC. Analyses according to PUC severity revealed that patients with severe PUC had higher prostate-specific antigen (PSA) level (P = 0.009), higher total IPSS (P < 0.001), lower Qmax (P = 0.002), and smaller prostate volume (P < 0.001), compared with patients who had non-severe (mild or moderate) PUC. Multivariate analysis showed that distal PUC was independently associated with high total IPSS (P = 0.02), voiding symptom score (P = 0.04), and storage symptom score (P = 0.023), and low Qmax (P = 0.015). In conclusion, PUC was significantly associated with worse LUTS parameters in terms of IPSS and Qmax. Furthermore, distally located PUC was independently associated with worse LUTS of BPH in men.

Electron microscopic changes of detrusor in benign enlargement of prostate and its clinical correlation

ABSTRACT Aims: To study the ultra structural changes in bladder musculature in cases of BPE and their clinical relevance. Material and Methods: In this descriptive longitudinal, controlled, observational study patients were enrolled into three groups, group 1, group 2A and group 2B. Control group (group-1) consisted of age matched normal male patients, who underwent surveillance or diagnostic cystoscopy for microscopic hematuria or irritative symptoms. Case group (group-2) comprised of patients with BPE, undergoing TURP. Case group (group-2) was further classified into: Category 2A (patients not on catheter) and category 2B (patients on catheter). All relevant clinical parameters like IPSS, prostate size, Qmax, PVR were recorded. Cystoscopy and bladder biopsy were performed in all patients. Various ultrastructural parameters like myocytes, fascicular pattern, interstitial tissue, nerve hypertrophy and cell junction pattern were analyzed under electron microscope and they were clinically correlated using appropriate statistical tests. Results: Control group had significant difference as compared to case group in terms of baseline parameters like IPSS, flow rate and prostate size, both preoperatively and postoperatively, except for PVR, which was seen only preoperatively. There was statistically significant difference in ultrastructural patterns between case and control group in all five electron microscopic patterns. However, no significant difference was found between the subcategories of case groups. Conclusions: BPE is responsible for ultra structural changes in detrusor muscle and these changes remain persistent even after TURP. Nerve hypertrophy, which was not thoroughly discussed in previous studies, is also one of the salient feature of this study.

Evaluation of prostatic diseases with transrectal ultrasonography

A study was conducted in radiology department CMH Rawalpindi to determine the role of transrectal ultrasonography in the evaluation of prostatic diseases. A total of 78 cases were examined with transrectal ultrasound probe and later followed for histopathological findings. Transrectal ultrasound was found correct in 51 cases of benign prostatic hyperplasia and 16 cases of prostatic carcinoma. Two cases of prostatitis with prostatic abscess were also noted. The sensitivity and positive predictive value for prostatic carcinoma in our study were 80% and 76.19% respectively. In 16 cases of prostatic carcinoma, the digital rectal examination was positive in only 08 cases and raised serum prostate specific antigen were noted in 13 cases. In view of this study, it is recommended that transrectal ultrasonography should be adopted for pre-operative assessment of benign prostatic hyperplasia, diagnosis / staging of prostatic carcinoma and in all clinically suspected cases of prostatic abscess

Value of transrectal ultrasonography in prostatic diseases

Transrectal ultrasonography is a new addition in the armamentarium of urologists. We at Jinnah Hospital/Lahore General Hospital, are using this technique for the imaging of the prostate for the five years. In this paper we have described our experience regarding its value in the detection of prostatic diseases and precision of the transperineal biopsy under its guidance. Two hundred and seventy two transerctal prostatic ultrasonograms were received and the findings compared with the final pathological or clinical diagnosis. A high degree of accuracy was achieved in diagnosing benign prostatic hyperplasia. Transrectal ultrasonography proved invaluable in staging proven prostatic carcinomas but it was disappointing as a primary diagnostic tool for cancer with a high false positive and negative rates of 11.98% and 33.72% respectively. These finding are discussed in the light of other workers' results

[Radiographic investigation of prostatic hyperplasia]

Radiographic changes of aprostatic enlargement in 25 cases which had caudal abdominal Radiography during the year 1989 had been investigated in relation to AGE.%68 of cases had hyperplasic prostate with the age - average of was 7.2 years [between 2 to 15 years]. From 17 cases with Radiographic signs of prostatic Hyperplasia, 10 cases had no clinical signs [%58.2] and 7 cases had clinical signs like constipation, urinary retention and hinlimb jameness. Lameness was the only clinical signs in one cases of prostatic hyperplasia