PURPOSE: To determine the relative accuracy of transrectal ultrasonographic measurement of prostate volume in comparison to actual volume of prostate and its clinical application. MATERIALS AND METHODS: Forty-five benign prostate hyperplasia patients who were undergone transrectal ultrasonography for prostatic volume estimation in Kosin university hospital were selected. Prostate models in equal size with ultrasonographically estimated prostatic size were made and used as model I group. We also made twenty prostate models in different size and used as model II group. We compared measurement of ultrasonographic volume of prostate model with actual volume of prostate model in two groups. RESULTS: In model I group, the most accurate method in estimating prostate volume was variation of the spheroid formula with correlation coefficient of 0.892 and then ellipsoid formula with correlation coefficient of 0.887. In model II group, the most accurate method in estimating prostate volume was ellipsoid formula with correlation coefficient of 0.945 and then variation of the spheroid formula with correlation coefficient of 0.929. CONCLUSIONS: When different volume ranges were considered, it was suspected that ellipsoid formula provided the closest estimate of prostate volume in less than 50cc range and variation of the spheroid formula in more than 50cc range in estimating the prostate volume.
Humans ; Hyperplasia ; Prostate* ; Ultrasonography

Transrectal ultrasonography (TRUS) in prostate cancer could show the images of multiform prostate adenomas. Specific sign is a hypoechoic area in periphery of gland. Overall, sensitivity (32%) and specificity (51%) of TRUS in diagnosis prostate cancer weren’t high. The false negative was from 30% to 40%. Two major roles of TRUS were to determine suspected lesions and to increase accuracy of prostate biopsy. TRUS techniques in diagnosis prostate cancer were: conventional TRUS, TRUS with Doppler, TRUS with contrast Doppler, and TRUS with 3D ultrasound. Under TRUS-guiding, biopsy can be performed through perineum or rectum
Prostate ; Biopsy ; Ultrasonography

30 benign prostate hyperplasia (BPH) and 20 prostate carcinoma patients whom confirmed pathologically, admitted in recent 4 months, were reviewed with transrectal ultrasonogram of prostate. The BPH was characterized by transversely elongated, symmetrical shape, evan capsule with regular continuity and homogenous or hyperechogenicity. But prostate carcinoma showed anteroposteriorly elongated, asymrnetrical shape, irregular, thickened or interrupted capsule and hypoechogenicity or mixed echogenicity. The diagnostic accuracy of BPH was 97% but the prostate carcinoma was 85%. The resolution and precision of the prostate image, especially on the prostate capsule, were more accurate than any other imaging modalities and the combination with them, we can establish the most accurate staging and appropriate treatment plan.
Humans ; Hyperplasia ; Prostate* ; Ultrasonography

No abstract available.
Diagnosis* ; Prostate* ; Prostatic Neoplasms* ; Ultrasonography*

PURPOSE: We investigated the efficacy of various parameters by transrectal ultrasonography (TRUS), and PSA levels, as predictors for the effectiveness of alpha-blocker(terazosin) monotherapy. MATERIALS AND METHODS: We evaluated 126 benign prostatic hyperplasic (BPH) patients, who underwent alpha-blocker (terazosin) monotherapy, according to their International Prostate Symptom Score (IPSS), peak flow rate (Qmax), prostate specific antigen(PSA), total prostate volume (TPV), transition zone volume (TZV) and transition zone index (transition zone volume/total prostate volume, TZI) for prediction the response to alpha-blocker (terazosin) monotherapy in men with symptomatic BPH. The patients were categorized into two groups; the good result, and the poor result groups. RESULTS: Following medication with terazosin, the IPSS decreased and the Qmax was significantly increased in all patients. However, according to the patients' subjective satisfaction of the treatment, those in the good result group (64 patients) had smaller TPV and TZV than those in the poor result group (61 patients). There were no significantly differences in PSA and TZI between the two groups. CONCLUSIONS: Terazosin was effective in reducing the symptoms and the improving peak flow rates in symptomatic BPH patients. TPV and TZV correlated significantly with the evaluated parameters in symptomatic BPH patients who underwent alpha-blocker monotherapy.
Humans ; Hyperplasia* ; Male ; Prostate* ; Prostate-Specific Antigen* ; Prostatic Hyperplasia ; Ultrasonography

PURPOSE: There is debate whether transition zone index is correlated with the parameters of benign prostatic hyperplasia. The purpose of this study was 3-fold: 1) to determine if transition zone index is correlated with the symptom score and peak flow rates of clinical benign prostatic hyperplasia, 2) to determine if transition zone index is correlated with the symptom score and peak flow rates of clinical benign prostatic hyperplasia after TURP, and lastly 3) to determine if the improvement of symptom score and peak flow rates after TURP is different according to transition zone index. MATERIALS AND METHODS: Fifty eight men, who underwent TURP, were measured total prostate volume and transition zone volume by trasnsrectal ultrasonography. All men were requested to undergo uroflowmetry and intermational prostate symptom score(IPSS), before and after TURP. RESULTS: The significant correlation between transition zone index and IPSS(p = 0.0001, R2 = 0.3652), and the relationships between transition zone index versus peak flow were not statistically significant(p = 0.79, R2 = 0.0015) before TURP. A weak relationship was observed between transition zone index versus IPSS(p = 0.0019, R2 = 0.16), peak flow rate(p = 0.022, R2 = 0.0811) after TURP. The improvement of IPSS and peak flow rate showed statistically significant difference according to transition zone index(p = 0.0001, 0.0787) CONCLUSIONS: The higher transition zone index, the more favorable outcome of transurethral resection of prostate was expected. On the contrary, the lower transition zone index, the less favorable outcome. So transition zone index can be used as a factor predicting the outcome of transurethral resection of prostate. The patient with lower transition zone index may have other factors affecting improvement of symptoms and peak flow rate in addition to obstruction.
Humans ; Male ; Prostate ; Prostatic Hyperplasia* ; Transurethral Resection of Prostate* ; Ultrasonography

Purpose: We evaluated the improvement in the rate of prostate cancer detection with the use of an extensive 12-site biopsy protocol in patients with only an elevated level of serum prostate-specific antigen (PSA). Materials and Methods: A total of 109 men with elevated PSA levels between 3 and 20ng/ml, but with no abnormal finding on digital rectal and transrectal ultrasound examinations, received transrectal ultrasound- guided prostate biopsies, which were performed at 12 sites, including the routine sextant and 6 far lateral regions (lateral apex, mid-lobe and base). The improvement in the detection rate was assessed according to the PSA level and prostate volume. Results: The mean age and PSA level of the patients were 63.5 8.6 years and 7.0 3.7ng/ml, respectively. Twenty-eight (25.7%) out of 109 men were diagnosed with prostate cancer. A traditional sextant biopsy detected 19 (67.9%) of the 28 prostate cancer patients, while 9 (32.1%) cancers were detected in the lateral region only. Overall, this extensive protocol resulted in a significant improvement, 8.3% (17.4 to 25.7%), in the detection rate (p=0.032). The improvement in men with a PSA of 10 ng/ml or less was 8.1% (14.0% to 22.1%, p=0.007) and in those with a PSA greater than 10 ng/ml the improvement was 8.7% (30.4% to 39.1%, p=0.162). The improvement in men with a prostate volume of 50cc or less was 8.0% (22.3% to 30.3%, p=0.083) and in those with a prostate volume greater than 50cc this was 9.1% (6.1% to 15.2%, p=0.043). Conclusions: The twelve-site biopsy protocol is a more efficient method in men with a PSA and prostate volume of 10ng/ml or less and greater than 50cc, respectively, compared to the sextant protocol.
Biopsy* ; Humans ; Male ; Prostate ; Prostate-Specific Antigen* ; Prostatic Neoplasms ; Ultrasonography

PURPOSE: The prostate specific antigen, PSA, may be elevated in patients with benign prostatic diseases. Prostatic calculi are very common, but little is known for their effect on the level of PSA. The relationship between prostatic calculi and PSA were analyzed. MATERIALS AND METHODS: A total of 486 patients were evaluated with transrectal an ultrasound (TRUS), and the PSA determined. The patients were divided into the calculi (n=198, 40.6%) and non calculi groups (n=288, 59.4%), according to the presence of prostatic calculi in the TRUS. These groups were further divided into low PSA (PSA<4ng/ml) (n=417) and high PSA groups (PSA=4ng/ml) (n=69), according to serum PSA levels. The prostatic calculi volume was calculated using a transrectal ultrasonographic volume determination, based on the HWL principle (HeightxWidthxLengthx pi/6). RESULTS: The mean volume of the prostatic calculi was 257mm3, which was correlated with the age (p<0.01). The median serum PSA concentration was 2.11ng/ml for all the patients: 2.16ng/ml for the calculi group and 2.08ng/ml for the non-calculi group. The serum PSA concentration was higher in the calculi group, but there was no statistical significant between the two groups (p>0.05). The serum PSA concentration was not correlated with the calculi volume (p>0.05). The difference in the proportion of patients with prostatic calculi was not statistically significant between the low and high PSA groups (p>0.05). The mean volumes of prostatic calculi were 264 and 214mm3 in the low and high PSA groups, respectively, but these were not significantly different between the two groups (p>0.05). CONCLUSIONS: The presence, or volume, of prostatic calculi, as detected by TRUS, has no significant effect on the serum PSA level.
Calculi* ; Humans ; Prostate* ; Prostate-Specific Antigen* ; Prostatic Diseases ; Ultrasonography*

This study was aimed to investigate the possible correlations between International Prostate Symptom Score (IPSS), volume of total and transition zone of prostate, and serum prostate specific antigen (PSA) level in 42 patients diagnosed and treated as benign prostatic hyperplasia. We got IPSS by interview and calculated the volume of the total and the transition zone (TZ vol) of prostate by transrectal ultrasonography. The size of the total prostate was 37.35+/-12.9 cc (mean+/-standard deviation) and that of the transition zone was 17.72 +/- 10.04 cc. Transition zone index(transition zone volume/total prostate volume, TZ index) was calculated and its value was 0.45 +/- 0.14. Symptom score was not correlated with total prostate volume, TZ volume or 72 index (r=0.27, p>0.05; r=0.23, p>0.05; r=0.16, p>0.05, respectively). Either it did not show correlation with serum PSA level (r=0.16, p>0.05). However, there were statistically significant correlations among serum PSA, total volume, TZ volume, TZ index (r=0.66, p<0.05; r=0.64, p<0.05; r=0.47, p<0.05). From these results, it is difficult to find significant correlations between symptom severity easured by IPSS and several clinical indices such as total prostate volume, transitional volume, TZ index or serum PSA level. Prospective study including developing a more objective symptom scoring system is needed to get a more useful clinical index reflecting the symptom severity of the BPH patients as well as clinical status of them.
Humans ; Prostate* ; Prostate-Specific Antigen ; Prostatic Hyperplasia* ; Ultrasonography*

PURPOSE: Transrectal ultrasonography is known to be an effective tool for the determination of prostatic volume. But the irregularity of shape and the limitation of reliability by intra-observer and inter-observer bias may influence over the results. I would like to represent several factors for the error of transrectal ultrasonographic measurement of prostatic volume. MATERIALS AND METHODS: Errors for transrectal ultrasonographic volume determination of the prostate, based on the principle of HWL(Height x Width x Length x pi/6) are presented. Some artificial prostatic models were made and compared between the real volumes and calculated results. The intra-observer error was determined in 39 cases by repeated measurements. The inter-observer error was also determined in 32 cases by repeated measurements of different observer. RESULTS: There were significant discrepancies between real volumes and calculated results and the range of error by shape was -19?38%. The ranges of intra-observer and inter-observer errors with 95% confidence interval were -7.4?6.1% and 2.7?9.9%. CONCLUSIONS: Errors by several factors should be considered for the clinical application of measured prostatic volume by ultrasonography irrespective of its statistical validity and reliability.
Bias (Epidemiology) ; Prostate ; Reproducibility of Results ; Ultrasonography*