To define the practical value of prostatic needle biopsy in patients with suspicious prostatic carcinoma we studied the analysis of the clinical records of 49 patients underwent the prostatic needle biopsy at Severance Hospital during the 5 year period from 1976 through 1980. Forty-nine patients had been biopsied; carcinoma was found in 3 of 15 patients (20 per cent) not having prostatic induration, 6 of 17 (35 per cent) with minimal or equivocal induration and 12 of 17 (71 per cent) with marked induration. The results suggest that the vast majority of the patients with prostatic carcinoma has some degree of palpable induration and that a high index of suspicion appears warranted and needle biopsyshould be performed when any prostatic induration is present on digital rectal examination.
Biopsy, Needle* ; Diagnosis* ; Digital Rectal Examination ; Humans ; Needles* ; Prostatic Neoplasms

The diagnostic methods of evaluating infravesical obstruction, especially in BPH, are based on symptoms, history, digital rectal examination, intravenous pyelography, ultrasonography, uroflowmetry and residual urine, etc. But these methods cannot accurately and objectively evaluate infravesical obstruction. We measured voiding cystometry with uroflowmetry and urethral pressure profile in 24 BPH patients by Dantec UD5500. We classified the degree of obstruction into obstructive, equivocal and nonobstructive types by Griffiths' obstructive nomogram and Type 0 - VI by Schaefer's nomogram after computer assisted pressure-flow analysis. Among 24 patients, obstructive type was in 12, equivocal type in 6, and nonobstructive type in 6 by Griffiths' obstructive nomogram. Based on Schaefer's nomogram, type 0 was in 4 patients, type I in 6, type III in 4, type IV in 2, type V in 4 and type VI in 4. In our analyzed urodynamic parameters, Qmax, Pdet, Pmuo, Atheo and URA had statistical significance(p<0.05). We consider Griffiths' obstructive nomogram and Schaefer's nomogram based on pressure flow plot are objective methods of accurately evaluating infravesical obstruction.
Digital Rectal Examination ; Humans ; Nomograms ; Ultrasonography ; Urodynamics ; Urography

PURPOSE: Anastomotic leakage following surgery is one of the most significant causes of morbidity and mortality. Therefore, prevention of anastomotic leakage is crucial for safe rectal surgery. The aim of this study is to determine the effect of Mallecot(R) insertion on the prevention of anastomotic leakage after low rectal anastomosis. METHODS: From January 2002 to December 2006, 264 rectal cancer surgeries were performed in one center and by one surgeon. Among them, 110 cases whose anastomosis was located below 6 cm from the anal verge were collected and reviewed retrospectively. We made a diverting stoma on 6 out of 20 patients with high risk of anastomotic leakage, and inserted Mallecot(R) on the remaining 14 patients transanally. Removal of Mallecot(R) was done at the 7th postoperative day after a digital rectal examination to identify the completeness of anastomosis had been performed. RESULTS: Totally, anastomotic leakage occurred in 8 of 110 patients (73%). Among the 90 patients without any preventive measures, 7 incidents of anastomotic leakage were observed; on the other hand, 1 of 14 patients with Mallecot(R) insertion suffered anastomotic leakage. In two of the patients with leakage, including 1 in the Mallecot(R) group, the leakage was resolved via percutaneous drainage; in the other 6 patients were reoperated. CONCLUSIONS: The importance of preventing an anastomotic leakage after low rectal surgery cannot be overemphasized to reduce morbidity and to improve the prognosis. In addition, Mallecot(R) insertion may be an alternative method for diverting stoma formation.
Anastomotic Leak ; Digital Rectal Examination ; Drainage ; Hand ; Humans ; Mortality ; Prognosis ; Rectal Neoplasms ; Retrospective Studies

PURPOSE: Although the height of a rectal tumor above the anal verge (tumor height) partly determines the treatment strategy, no practical standard exists for reporting this. We aimed to demonstrate the differences in tumor height according to the diagnostic modality used for its measurement. METHODS: We identified 100 patients with rectal cancers located within 15 cm of the anal verge who had recorded tumor heights measured by using magnetic resonance imaging (MRI), colonoscopy, and digital rectal examination (DRE). Tumor height measured by using MRI was compared with those measured by using DRE and colonoscopy to assess reporting inconsistencies. Factors associated with differences in tumor height among the modalities were also evaluated. RESULTS: The mean tumor heights were 77.8 ± 3.3, 52.9 ± 2.3, and 68.9 ± 3.1 mm when measured by using MRI, DRE, and colonoscopy, respectively (P < 0.001). Agreement among the 3 modalities in terms of tumor sublocation within the rectum was found in only 39% of the patients. In the univariate and the multivariate analyses, clinical stage showed a possible association with concordance among modalities, but age, sex, and luminal location of the tumor were not associated with differences among modalities. CONCLUSION: The heights of rectal cancer differed according to the diagnostic modality. Tumor height has implications for rectal cancer’s surgical planning and for interpreting comparative studies. Hence, a consensus is needed for measuring and reporting tumor height.
Colonoscopy ; Consensus ; Digital Rectal Examination ; Humans ; Magnetic Resonance Imaging ; Multivariate Analysis ; Phenobarbital ; Rectal Neoplasms ; Rectum

Anal diseases are very common and it is important for a medical practitioner to understand how to deal with these diseases. To establish diagnoses of specific conditions, detailed history taking, inspection, palpation including digital rectal examination, and anoscopic examination are performed. Sigmoidoscopy is also required if upper lesions are suspected. History taking should include information about bleeding, prolapse, swelling, pain, discharge, irritation, bowel habit, continence, abdominal symptoms, weight loss. Sims' position and lithotomy position are commonly used for physical examination of the anal area. In addition to careful inspection and palpation, digital rectal examination should be performed to evaluate the anal canal width and sphincter strength. Above all, digital examination is a very useful and cheap tool to find rectal cancer which commonly occurs after middle-ages. Common anal diseases such as hemorrhoids, anal fissure, perianal abscess and fistula-in-ano, pruritus anai, and rectal prolapse are reviewed.
Abscess ; Anal Canal ; Diagnosis* ; Digital Rectal Examination ; Fissure in Ano ; Hemorrhage ; Hemorrhoids ; Palpation ; Physical Examination ; Prolapse ; Pruritus ; Rectal Neoplasms ; Rectal Prolapse ; Sigmoidoscopy ; Weight Loss

Hematospermia is not an uncommon condition that has brought many patients to doctor's office. In many cases hematospermia is self-limiting and no clear etiology is discovered. Transrectal ultrasonography (US) was performed in 16 patients with hematospermia to evaluation its efficacy in determination of cause. 1. Hematospermia occurred in 16 patients range from 19 to 63 years of age with average of 34. years. Half of them were in the third and a fifth in the fourth decade. 2. In all of patients, urinalysis and urine culture were normal. Rectal palpation and microscopic examination of prostatic secretion had no value in determination of cause of hematospermia. 3. Among the 12 patients who had abnormal transrectal US findings, 4 patients had lesions in seminal vesicle, 3 in prostate and 3 in both. In 2 patients Millenarian duct cysts were found. 4. Among the abnormal US findings, hematoma of seminal vesicle and calcification of prostate were common followed by enlargement of seminal vesicle. The results provide that transrectal ultrasonography is easy and effective method in evaluation of patients with hematospermia.
Digital Rectal Examination ; Hematoma ; Hemospermia* ; Humans ; Prostate ; Seminal Vesicles ; Ultrasonography* ; Urinalysis

We measured the concentration of serum PSA and prostatic acid phosphatase for studying the usefulness of PSA in 145 cases with BPH and 24 cases with prostate cancer. PSA was more sensitive and same specific as PAP in diagnosis of prostate cancer(n < or = 20 ng/ml). The diagnostic accuracy and positive predictive rate or PSA were higher than PAP, positive predictive rate war highest in PSA(n < or = 10 ng/ml) with abnormal digital rectal examination. PSA was a simple and useful method for detection of prostate cancer. But, by strict statistical criteria alone, PSA by itself didn`t qualify as an effective screening tool. By combination with digital rectal examination and transrectal ultrasonography, it may be useful in early detection of prostate cancer.
Acid Phosphatase ; Diagnosis ; Digital Rectal Examination ; Mass Screening ; Prostate* ; Prostate-Specific Antigen* ; Prostatic Neoplasms* ; Ultrasonography

A clinical study was made on the 28 cases underwent prostatectomy during the 5 year-period from 1964 to 1968. The results are summarized as follows: 1. The patient underwent prostatectomy revealed increasing tendency in incidence, residual urine in average and being usually in the age range between 60 and 70 years. 2. The degree of prostatic enlargement was mostly grade 11 on rectal palpation and the removed prostate was 49. 3gm. in average weight. 3. Blood loss attributable to the operative manipulation was 1143 cc. in average. The patients underwent prostatectomy were discharged on the average 21.3 days postoperatively in which postoperative indwelling catheter was left in place for 15.3 days in average. 4. Postoperatively the convalescence was uneventful and the residual urine was disappeared or decreased markedly. 5. In the patients underwent prostatectomy via retropubic approach operative blood loss was mild and postoperative duration of indwelling catheterization was short as compared to that via the suprapubic approach. 6. No serious complication other than epididymitis developed in a few patients was observed postoperatively. 7. Suprapubic prostatectomy was found to be suitable for the patient with marked prostatic enlargement while the retropubic one yielded less tissue damage and somewhat rapid postoperative convalescence as compared to the former.
Catheters, Indwelling ; Convalescence ; Digital Rectal Examination ; Epididymitis ; Humans ; Incidence ; Male ; Prostate ; Prostatectomy*

BACKGROUND: This study was performed to reconsider the efficacy of transrectal ultrasonography (TRUS) in diagnosing prostate cancer by analyzing the results of a digital rectal examination (DRE), serum prostate-specific antigen (PSA) and a transrectal ultrasono- graphy in patients with prostate specific antigen levels of 10 ng/ml or less. MATERIALS AND METHODS: One-hundred and eighty one men with PSA levels of 10 ng/ml or less, who had a TRUS-guided tissue biopsy performed, were included in this study. The detection rate of prostate cancer was compared according to the TRUS result and the presence or absence of nodularity and the consistency of the prostate on DRE. RESULTS: In a total 181 patients, there were 73 patients with PSA levels of 4 ng/ml or less and 4 of them had prostate cancer. Thre were 108 patients with PSA levels of 4-10 ng/ml and 18 of them were prostate cancer. TRUS was performed in 152 patients and 16 out of 58 patients diagnosed with prostate cancer, 3 out of 39 diagnosed with suspicious prostate cancer, and 2 out of 55 patients diagnosed as having no prostate cancer were found to have prostate cancer. In 40 patients, a nodule was palpated on DRE and 8 of them were found to have prostate cancer. Five out of 19 patients with a stony hard consistency, 3 of 12 with a firm to hard consisency, 12 of 129 with a firm consistency, 0 of 13 with a soft to firm consistency, and 2 of 8 with a soft consistency were prostate cancer. In the prostate cancer patients, there were 4 patients with PSA levels of 4 ng/ml or less and all these patients were diagnosed with prostate cancer or suspicious prostate cancer on TRUS but the nodule was not palpated in all patients. Two were soft and 2 were firm consistency on DRE. CONCLUSION: In patients with serum PSA levels of 10 ng/ml or less, TRUS is a more useful supporting method than DRE and a more active application of TRUS may lead to an early diagnosis and pertinent treatment of prostate cancer.
Biopsy ; Digital Rectal Examination ; Early Diagnosis ; Humans ; Male ; Prostate* ; Prostate-Specific Antigen* ; Prostatic Neoplasms* ; Ultrasonography*

PURPOSE: To investigate the relationship of transrectal ultrasound (TRUS) findings with the pathological characteristics of prostate cancer (PCa). MATERIALS AND METHODS: The study was conducted retrospectively by analyzing the data for 970 patients who underwent prostate biopsies. Gleason scores and other clinical variables were compared between PCa patients with and without hypoechoic lesions on TRUS. RESULTS: Of the 970 patients, PCa was diagnosed in 291 (30%). Of these, high-grade PCa (Gleason score of 7 or more) was diagnosed in 190 (65%). The cancer detection rate was higher in patients with hypoechoic lesions (43.9%) than in those without hypoechoic lesions (21.4%, p<0.001). High-grade PCa was detected more often in patients with hypoechoic lesions than in those without hypoechoic lesions (p<0.001). Independent predictors for high-grade PCa by logistic regression analysis included hypoechoic lesions on TRUS and abnormal digital rectal examination findings. CONCLUSIONS: Patients with PCa who had hypoechoic lesions on TRUS had more aggressive pathological disease than did those without lesions. Therefore, hypoechoic lesions on TRUS could be a marker for clinically significant PCa.
Biomarkers ; Biopsy ; Digital Rectal Examination ; Humans ; Logistic Models ; Passive Cutaneous Anaphylaxis ; Prostate ; Prostatic Neoplasms ; Retrospective Studies