ABSTRACT
Background and objective: Benign prostatic hyperplasia manifests as lower urinary tract symptoms (LUTS) and prostate gland enlargement, leading to bladder outlet obstruction with consequent structural and functional impacts on the bladder. Urodynamic studies are resource-intensive and invasive. Detrusor wall thickness (DWT) assessment offers a cost-effective, reproducible alternative for evaluating LUTS severity in males with bladder outlet obstruction, utilizing ultrasonographic examination. Methods: This prospective cross-sectional study, conducted at a tertiary care center from May 2023 to January 2024, included 171 patients with LUTS who underwent transabdominal ultrasound for DWT measurements. LUTS severity, assessed using International Prostate Symptom Scores (IPSS) classified participants into mild and moderate-to-severe symptom groups. Pearson's correlation coefficient assessed the association between DWT and IPSS, and an independent sample t-test compared means, using a significance level of 5% (P-value ≤0.05). Results: This study involved participants aged 65.01±11.55 years with an IPSS score ranging from 1 to 35, with a mean for mild and moderate-to-severe symptom groups were 4±2.12 and 15.93±6.74, respectively. DWT mean of 1.64±0.38 mm for mild, and 2.4±0.43 mm for moderate to severe symptoms. Pearson's correlation (r=0.697, n=171, P<0.001) indicated a strong DWT-LUTS correlation and a significant DWT mean difference between mild and moderate-to-severe symptom groups was found via an independent t-test (P<0.001, 95% CI: -0.8970 to -0.6414). Conclusion: The study establishes the value of transabdominal ultrasound-detected DWT as a cost-effective, noninvasive, and reproducible tool for assessing LUTS severity in males with benign prostatic hyperplasia.
ABSTRACT
Thoracic lipomyelomeningocele is a rare type of congenital occult spinal dysraphism. It is characterized by lipomatous tissue connected to the dorsal spinal cord that protrudes through a spinal defect together with the meninges or spinal cord to form a posterior mass beneath the skin. Closed spinal dysraphism can present diagnostic challenges when resources are scarce and advanced imaging techniques like magnetic resonance imaging are not readily available. Here, we describe a case of thoracic lipomyelomeningocele, a type of closed spinal dysraphism in a young female presenting with gradually progressive weakness and tingling sensation in bilateral lower limbs over the last 6 months. On physical examination, she had a soft tissue swelling with dimpling over the dorsal spine and paraparesis. Magnetic resonance imaging of the spine revealed dorsal lipomyelomeningocele corresponding to D4-D7 vertebral levels with tethered spinal cord.
ABSTRACT
Congenital adrenal hyperplasia includes defects in the synthesis of steroid hormones in the adrenal cortex. The implications of this disorder manifest in other genitourinary organs, including ovaries and uterus. The diagnosis may be suspected based on the clinical and radiologic features.
