Evaluation of transitional zone index as a BPH parameter

Can transitional zone index [the ratio belween transition zone volume and total prostate volume as measured by transrectal ultrasound] serve as a better proxy for clinical prostatism? We prospectively evaluated 60 patients with symptomatic BPH ;according to symptoms [AUA symptom score] peak urine flow [Q max] ;and detrusor pressure at peak urine flow, Transrectal ultrasound [TRUS] measurement of the prostate volume and the transition zone [TZ] volume was done and transition zone index [TZI] was calculated. We found that prostate volume insignificantly correlated with BPH parameters. TZI volume highly significantly and strongly correlated with BPH parameters and may serve as a useful proxy for evaluating worsening obstruction in BPH Key Words: Prostate. Prostate Hypenrophy

Ultrasonic prenatal diagnosis of congenital urinary tract abnormalities and postnatal follow-up of some cases

This study was perfomed in Zagazig University Hospitals during the period from January 1994 to June 1997. It included 15,000 pregnant females in their third trimester, their ages range from 18 - 42 years [mean 26 years]. For them; I] History taking, with special stress on points which may indicate potential fetal risk as diabetes mellitus and drugs or fever during pregnancy; 2] maternal-fetal ultrasonography [diagnostic fetal ultrasound] with special attention to the fetal genitourinary system and in particular examining the following items; the amniotic fluid volume, the fetal urinary bladder, renal size, shape and echogenicity, the presence of renal cysts, the presence of dilatation of the urinary tract, and any associated abnormalities. This resulted in the prenatal diagnosis of 24 fetuses with congenital urinary tract abnormalities [Table 1] with an incidence of 0.16%. These fetuses were followed during pregnancy and 9 infants of them were followed after birth by the appropriate diagnostic imaging techniques which confirmed the prenatal ultrasonographic diagnosis. These 9 infants were completely investigated, followed-up and surgically treated in our urology department [5 cases of Anderson-Hynes pyeloplasty for UPJ obstruction; 2 cases of ureterovesical reimplantation with submucous tunnel to prevent reflux, one case of PUVs treated by endoscopic destruction of the valves and one case of MCDK treated by Nephrectomy].These 9 cases were compared with a similar group of infants who were diagnosed later postnatally by urinary tract infections, abdominal pain and swellings. The results of surgery were compared in the two groups. There was a 70% incidence of diminished renal function in the postnatal group but only 20% of the prenatal group had low kidney function. So, it is clear from this work that earlier diagnosis of congenital urinary tract anomalies possible with prenatal ultrasound examination is important to start evaluation and treatment immediately after birth and before the occurrence of complications