ABSTRACT
Objetivo Los síntomas clínicos en la hiperplasia benigna de próstata (HBP) son directamente proporcionales al volumen de la próstata. Nuestro objetivo es definir el tipo de paciente que debe ser intervenido de forma no invasiva, así como el momento idóneo para esta intervención, correlacionando los síntomas subjetivos del paciente con las herramientas objetivas de diagnóstico. Material y método Se utilizó el cuestionario International Prostate Symptom Score (IPSS) en los pacientes que acudieron por primera vez a la consulta externa de urología con síntomas del tracto urinario inferior (STUI). A continuación, se solicitaron niveles de PSA, urea, creatinina, análisis de orina completos, uroflujometría, ecografía del tracto urinario y tomografía computarizada (TC) abdominal inferior sin contraste. Se registraron los valores de las unidades Hounsfield (UH) de la zona central (zona de transición) y de la zona periférica de la próstata, la longitud de la uretra prostática y los valores de UH de la pared vesical mediante la TC. Se utilizó la fórmula del elipsoide para las mediciones ultrasonográficas y tomográficas del tamaño de la próstata (diámetro anteroposterior × diámetro transversal × diámetro longitudinal × 0,52). Resultados Se halló una correlación negativa estadísticamente significativa entre la proporción de UH de la zona periférica de la próstata/zona central y el flujo máximo medido en la uroflujometría. Conclusión Este es el primer estudio de la literatura en evaluar la correlación entre los parámetros miccionales, como las puntuaciones de Qmáx, Qave e IPSS, y las puntuaciones de UH de la próstata y la pared vesical obtenidas mediante TC en pacientes con HBP. Se ha detectado una relación significativa entre la proporción de UH de la zona periférica/zona central y Qmáx (AU)
Objective The clinical symptoms in benign prostatic hyperplasia (BPH) are directly proportional to prostate volume. We aimed to show whom and when to intervene in a noninvasive way, correlating the patient's subjective symptoms with objective diagnostic tools. Material and method International Prostate Symptom Score (IPSS) was evaluated in patients who consulted the urology outpatient clinic for the first time with lower urinary tract symptoms (LUTS). Subsequently, PSA, urea, creatinine, complete urinalysis, uroflowmetry, urinary tract ultrasound and non-contrast lower abdominal computed tomography (CT) examinations were requested. Prostate central (transitional zone) zone and peripheral zone HU scores, prostatic urethral length and bladder wall Hounsfield units (HU) scores were recorded by using computed tomography (CT). The ellipsoid formula was used for ultrasonographic and tomographic measurements of prostate size (anteroposterior diameter × transverse diameter × longitudinal diameter × 0.52). Results A statistically significant negative correlation was found between the prostate peripheral zone/central zone HU ratio and the maximum flow rate measured in the uroflowmetry test. Conclusion This is the first study in the literature to evaluate the correlation between voiding parameters such as Qmax, Qave and IPSS scores, and prostate and bladder wall HU scores obtained by computed tomography examination in BPH patients. A significant relationship has been detected between the peripheral zone/central zone HU ratio and Q max. Additional studies with larger patient populations could better clarify the contribution of HU in the diagnosis of BPH and treatment decision making of these patients (AU)
Subject(s)
Humans , Male , Middle Aged , Aged , Prostatic Hyperplasia/diagnosis , Lower Urinary Tract Symptoms , Prostate-Specific Antigen , Tomography, X-Ray Computed , Lower Urinary Tract Symptoms/etiology , Lower Urinary Tract Symptoms/diagnostic imagingABSTRACT
OBJECTIVE: The clinical symptoms in benign prostatic hyperplasia (BPH) are directly proportional to prostate volume. We aimed to show whom and when to intervene in a noninvasive way, correlating the patient's subjective symptoms with objective diagnostic tools. MATERIAL AND METHOD: International Prostate Symptom Score (IPSS) was evaluated in patients who consulted the urology outpatient clinic for the first time with lower urinary tract symptoms (LUTS). Subsequently, PSA, urea, creatinine, complete urinalysis, uroflowmetry, urinary tract ultrasound and non-contrast lower abdominal computed tomography (CT) examinations were requested. Prostate central (transitional zone) zone and peripheral zone HU scores, prostatic urethral length and bladder wall Hounsfield units (HU) scores were recorded by using computed tomography (CT). The ellipsoid formula was used for ultrasonographic and tomographic measurements of prostate size (anteroposterior diameterâ¯×â¯transverse diameterâ¯×â¯longitudinal diameterâ¯×â¯0.52). RESULTS: A statistically significant negative correlation was found between the prostate peripheral zone/central zone HU ratio and the maximum flow rate measured in the uroflowmetry test. CONCLUSION: This is the first study in the literature to evaluate the correlation between voiding parameters such as Qmax, Qave and IPSS scores, and prostate and bladder wall HU scores obtained by computed tomography examination in BPH patients. A significant relationship has been detected between the peripheral zone/central zone HU ratio and Q max. Additional studies with larger patient populations could better clarify the contribution of HU in the diagnosis of BPH and treatment decision making of these patients.
Subject(s)
Lower Urinary Tract Symptoms , Prostatic Hyperplasia , Humans , Lower Urinary Tract Symptoms/diagnostic imaging , Lower Urinary Tract Symptoms/etiology , Male , Prostate/diagnostic imaging , Prostatic Hyperplasia/drug therapy , Urinary Bladder , UrinationABSTRACT
Objective: Studies have reported that the cribriform morphology observed in prostate biopsy is associated with increased up-staging, upgrading, positive surgical margins and aggressive prognosis after radical prostatectomy. In our study, we aimed to evaluate the relationship between cribriform morphology and biochemical recurrence in patients with moderate-risk localized PCa with a Gleason score of 3+4 (ISUP grade 2) after radical prostatectomy. Methods: Datas of 177 patients in the moderate-risk group who were evaluated as ISUP grade 2 after radical prostatectomy were retrospectively evaluated. Patients were divided into 2 groups as without (Group 1) and with biochemical recurrence (Group 2). Age, preoperative PSA level, T stage, follow-up time and presence of cribriform morphology in both groups were evaluated and compared. Results: The mean preoperative serum total PSA level (group 1: 8.2 ± 3.9 and group 2: 11.9 ± 4.7) and presence of cribriform morphology (group 1: 25 (16%) and group 2: 9 (42%)) was significantly higher in group 2 (p = 0.001 and p = 0.007, respectively). According to the results of univariate and multivariate logistic regression analysis, preoperative serum total PSA level and pres-ence of cribriform morphology were found to be independent risk factors for biochemical recurrence (OR: 4,4; %95 Cl: 1,6-11,7; p=0.003 and OR: 4,7; %95 Cl: 1,7-13,1; p=0,003, respectively). Conclusion: Cribriform morphology of PCa is a risk factor for biochemical recurrence in patients with moderate risk and GS 3+4. In this respect, individualizing PCa cases accompanied by cribriform morphology from other Gleason Score 3+4 cases seems to be an appropriate approach (AU)
