1.Clinical significance of distally located periurethral calcification in patients with lower urinary tract symptoms of benign prostate hyperplasia.
Seong Hyeon YU ; Do Gyeong LIM ; Sun-Ouck KIM
Asian Journal of Andrology 2023;25(3):361-365
This study evaluated the association of periurethral calcification (PUC) with uroflowmetric parameters and symptom severity in male patients with lower urinary tract symptoms (LUTS) of benign prostatic hyperplasia (BPH). The data were collected from a prospectively maintained database of 1321 men with LUTS of BPH who visited Chonnam National University Hospital (Gwang-ju, Korea) from January 2015 to December 2019. PUC severity and location were evaluated on the midsagittal plane during transrectal ultrasonography. Relationships among age, prostate-related parameters, International Prostate Symptom Score (IPSS), and uroflowmetric parameters were assessed. Among the 1321 patients in this study, 530 (40.1%) had PUC. Patients with PUC had significantly higher IPSS (mean ± standard deviation [s.d.]: 15.1 ± 8.7 vs 13.1 ± 7.9; P < 0.001) and lower peak flow rate (Qmax; mean ± s.d.: 12.4 ± 6.6 ml s-1 vs 14.7 ± 13.3 ml s-1; P < 0.001), compared with patients who did not have PUC. Analyses according to PUC severity revealed that patients with severe PUC had higher prostate-specific antigen (PSA) level (P = 0.009), higher total IPSS (P < 0.001), lower Qmax (P = 0.002), and smaller prostate volume (P < 0.001), compared with patients who had non-severe (mild or moderate) PUC. Multivariate analysis showed that distal PUC was independently associated with high total IPSS (P = 0.02), voiding symptom score (P = 0.04), and storage symptom score (P = 0.023), and low Qmax (P = 0.015). In conclusion, PUC was significantly associated with worse LUTS parameters in terms of IPSS and Qmax. Furthermore, distally located PUC was independently associated with worse LUTS of BPH in men.
Humans
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Male
;
Prostatic Hyperplasia/diagnostic imaging*
;
Prostate/diagnostic imaging*
;
Clinical Relevance
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Hyperplasia
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Lower Urinary Tract Symptoms/complications*
;
Calcinosis/diagnostic imaging*
2.Clinical significance of the parameters of prostate volume measured by TRUS in evaluating bladder outlet obstruction.
National Journal of Andrology 2003;9(7):522-526
OBJECTIVESTo explore the parameters of prostate volume measured by TRUS in diagnosing bladder outlet obstruction (BOO) from BPH.
METHODSProstate volume(PV), transition zone volume(TZV) and transition zone index (TZI) were measured with TRUS in 116 cases of BPH aged from 59-75. Urodynamics were conducted, including Qmax, Pdet. Qmax and AG value. The correlation analysis was performed among them.
RESULTSPV, TZV and TZI were (69.7 +/- 45.9) ml, (43.5 +/- 25.6) ml and 0.57 +/- 0.14, respectively. Qmax, Pdet. Qmax and AG were (8.31 +/- 5.12) ml/s, (82.34 +/- 33.47) cm H2O and 66.72 +/- 30.46, respectively. IPSS and PSA were 25.3 +/- 4.7 and (4.12 +/- 3.64) ng/ml, respectively. The correlation analysis showed TZI (r = 0.742, P = 0.017) and TZV (r = 0.674, P = 0.031) were positively correlated with AG value. IPSS was positively correlated with TZV and TZI. There was also a positive correlation between PSA and PV, TZV and TZI.
CONCLUSIONSAs urodynamics, the parameters of prostate volume measured by TRUS are reliable to diagnose BOO due to BPH.
Aged ; Humans ; Male ; Middle Aged ; Prostate ; diagnostic imaging ; Prostate-Specific Antigen ; analysis ; Prostatic Hyperplasia ; complications ; diagnostic imaging ; Ultrasonography ; Urinary Bladder Neck Obstruction ; diagnostic imaging ; etiology ; Urodynamics
3.New model of PIRADS and adjusted prostatespecific antigen density of peripheral zone improves the detection rate of initial prostate biopsy: a diagnostic study.
Chen HUANG ; Zong-Qiang CAI ; Feng QIU ; Jin-Xian PU ; Qi-Lin XI ; Xue-Dong WEI ; Xi-Ming WANG ; Xiao-Jun ZHAO ; Lin-Chuan GUO ; Jian-Quan HOU ; Yu-Hua HUANG
Asian Journal of Andrology 2023;25(1):126-131
This study explored a new model of Prostate Imaging Reporting and Data System (PIRADS) and adjusted prostate-specific antigen density of peripheral zone (aPSADPZ) for predicting the occurrence of prostate cancer (PCa) and clinically significant prostate cancer (csPCa). The demographic and clinical characteristics of 853 patients were recorded. Prostate-specific antigen (PSA), PSA density (PSAD), PSAD of peripheral zone (PSADPZ), aPSADPZ, and peripheral zone volume ratio (PZ-ratio) were calculated and subjected to receiver operating characteristic (ROC) curve analysis. The calibration and discrimination abilities of new nomograms were verified with the calibration curve and area under the ROC curve (AUC). The clinical benefits of these models were evaluated by decision curve analysis and clinical impact curves. The AUCs of PSA, PSAD, PSADPZ, aPSADPZ, and PZ-ratio were 0.669, 0.762, 0.659, 0.812, and 0.748 for PCa diagnosis, while 0.713, 0.788, 0.694, 0.828, and 0.735 for csPCa diagnosis, respectively. All nomograms displayed higher net benefit and better overall calibration than the scenarios for predicting the occurrence of PCa or csPCa. The new model significantly improved the diagnostic accuracy of PCa (0.945 vs 0.830, P < 0.01) and csPCa (0.937 vs 0.845, P < 0.01) compared with the base model. In addition, the number of patients with PCa and csPCa predicted by the new model was in good agreement with the actual number of patients with PCa and csPCa in high-risk threshold. This study demonstrates that aPSADPZ has a higher predictive accuracy for PCa diagnosis than the conventional indicators. Combining aPSADPZ with PIRADS can improve PCa diagnosis and avoid unnecessary biopsies.
Male
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Humans
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Prostate/pathology*
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Prostate-Specific Antigen/analysis*
;
Prostatic Neoplasms/diagnostic imaging*
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Biopsy
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Nomograms
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Retrospective Studies
4.A three-dimensional transrectal ultrasound imaging system.
Yimin CHEN ; Jian QI ; Mingyue DING ; Xuming ZHANG
Journal of Biomedical Engineering 2014;31(4):917-922
A three-dimensional (3D) transrectal ultrasound (TRUS) imaging system is presented in this paper. The 3D imaging system is used for diagnosing diseases of prostate. The 3D image is reconstructed by a series of two-dimensional image data which is obtained through rectum. It can be a guide to prostate needle biopsies. The system is built by two parts: hardware and software. In the hardware, the mechanical device, stepper motor, control circuit, B Mode TRUS and personal computer (PC) workshop are presented. The software includes the firmware of micro control unit and software of the PC workshop. In order to evaluate the performance of the 3D imaging system, we did experiments with water and agar phantoms, and the results demonstrated the system's ability of 3D imaging with high-precision.
Biopsy, Needle
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Humans
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Imaging, Three-Dimensional
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instrumentation
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Male
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Phantoms, Imaging
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Prostate
;
diagnostic imaging
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Rectum
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Software
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Ultrasonography
5.Sonographic features and clinical significance of transrectal ultrasonography in obstructive azoospermia.
Rong-pei WU ; Chun-hua DENG ; Hui LIANG ; Wan-mi ZHONG ; Wei-jie LIANG
National Journal of Andrology 2007;13(6):520-523
OBJECTIVETo investigate the ultrasonographic features of obstructive azoospermia and to evaluate transrectal ultrasonography in the diagnosis of the disease.
METHODSWe performed transrectal ultrasonography for 248 patients with obstructive azoospermia, observed the sonographic features of the prostate gland, seminal vesicle and ejaculatory duct.
RESULTSThe average volume of the prostate gland of the studied group was 13.2 ml. A total of 111 cases showed normal sonographic features, 39 cases bilateral seminal vesicle defect, 33 cases bilateral seminal vesicle aplasia, 23 cases unilateral seminal vesicle defect and contralateral seminal vesicle aplasia, 28 cases bilateral and 14 cases unilateral seminal vesicle dilatation. Of the 42 cases of seminal vesicle dilatation, 18 had ejaculatory duct dilatation and 17 had cysts in the midline of the prostate.
CONCLUSIONObstructive azoospermia varies in kind. Transrectal ultrasonography can reveal the details of the prostate, seminal vesicle and ejaculatory duct and help to classify obstructive azoospermia and determine the location of the lesion.
Adult ; Azoospermia ; diagnostic imaging ; Ejaculatory Ducts ; diagnostic imaging ; Humans ; Male ; Middle Aged ; Posture ; Prostate ; diagnostic imaging ; Rectum ; Seminal Vesicles ; diagnostic imaging ; Ultrasonography
6.Relationships between Prostatic Volume and Intravesical Prostatic Protrusion on Transabdominal Ultrasound and Benign Prostatic Obstruction in Patients with Lower Urinary Tract Symptoms.
Delin WANG ; Honghong HUANG ; Yan Mee LAW ; Keong Tatt FOO
Annals of the Academy of Medicine, Singapore 2015;44(2):60-65
INTRODUCTIONThe objective of this study is to determine the relationships between prostatic volume (PV) and intravesical prostatic protrusion (IPP) with benign prostatic obstruction (BPO).
MATERIALS AND METHODSA total of 408 males (aged 50 years and above) who presented with lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH) were recruited. All had International Prostate Symptoms Score (IPSS), quality of life (QOL) index, uroflowmetry (Qmax) and postvoid residual urine (PVR) measured by transabdominal ultrasonography (TAUS). The PV and the degree of IPP were also measured by TAUS in the transverse and sagittal planes respectively. The PV is classified as Grade a, (20 ml or less), Grade b, (more than 20 ml to 40 ml) and Grade c, (more than 40 ml), while the IPP is graded as Grade 1 (5 mm or less), Grade 2 (more than 5 mm to 10 mm) and Grade 3 (more than 10 mm).
RESULTSThere was a fair positive correlation between the PV and IPP (Spearman, r(s) = 0.62, P <0.001) with important clinical exceptions. There was negative correlation between the PV and Qmax (rs = -0.20, P = 0.022), IPP and Qmax (r(s) = -0.30, P <0.001). PV and IPP were good predictors of BPO. However, IPP was slightly better (r(s) of -0.30 vs -0.20) than PV.
CONCLUSIONPV is related to IPP with important clinical exceptions. IPP is a better predictor of BPO than PV.
Humans ; Lower Urinary Tract Symptoms ; diagnostic imaging ; pathology ; Male ; Middle Aged ; Prostate ; diagnostic imaging ; pathology ; Prostatic Hyperplasia ; diagnostic imaging ; Quality of Life ; Ultrasonography ; Urinary Bladder ; diagnostic imaging
8.Risk factors for prostate cancer in male patients with MRI-negative and PSA-abnormal findings.
Shao-Long E ; Yi-Xiao ZHANG ; Bin WU
National Journal of Andrology 2021;27(10):886-891
Objective:
To investigate the risk factors for clinically significant PCa diagnosed by transrectal ultrasound-guided systematic prostate biopsy in patients with MRI-negative and PSA-abnormal findings.
METHODS:
From January 2014 to December 2017, 335 male patients with MRI-negative (PI-RADS 2.0 score ≤ 2) and PSA-abnormal (4-30 ng/ml ) findings underwent systematic prostate biopsy guided by transrectal ultrasound under local anesthesia in our department. We collected and analyzed the demographic data, clinical symptoms, complications, past history and PSA density (PSAD) of the patients.
RESULTS:
Clinically significant PCa was diagnosed in 21 (6.3%) of the 335 patients. Multivariate logistic regression analysis showed that the independent risk factors were higher age (AUC: 0.704, P < 0.01) and PSAD (AUC: 0.743, P < 0.01). The cutoff values of age and PSAD were 71 years and 0.18 ng/ml/ml, respectively.
CONCLUSIONS
Higher age and PSAD are risk factors for clinically significant PCa. Prostate biopsy, even repeated or saturated puncture, is recommended for those aged >71 years old or with PSAD >0.18 ng/ml/ml so as to avoid missed diagnosis and unnecessary invasive biopsy as well. /.
Aged
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Humans
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Magnetic Resonance Imaging
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Male
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Prostate-Specific Antigen
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Prostatic Neoplasms/diagnostic imaging*
;
Risk Factors
9.Ultrasound-guided transrectal microwave ablation of the prostate in dogs.
Zhen-Cai LI ; Jing ZHANG ; Dong-Mei HU ; Qian LIU ; Mao-Hu LIN ; Jin-Tao REN ; Yu-Qing WANG ; Qiong WANG
National Journal of Andrology 2011;17(9):813-816
OBJECTIVETo investigate the feasibility and safety of ultrasound-guided transrectal microwave ablation in reducing the prostate volume.
METHODSUltrasound-guided transrectal microwave ablation of both sides of the prostate was conducted on experimental dogs with the output volume of 30W for 120 seconds. The dogs were sacrificed on the very day of the ablation, and the prostate and its surrounding tissues were excised for observation of the thermal lesions and pathological examination.
RESULTSA total of 12 thermal lesions were achieved on the two sides of the prostate. The ultrasonogram manifested dense echo and increasing extent in the ablated area, and then an irregular heterogeneous echogenic area and clearly differentiated margin. Pathological examination of the gross specimen showed a little stagnant blood under the rectal mucous, the urethra and bladder not injured, and the thermal lesions elliptical, clearly margined and with the mean size of (0.94 +/- 0.30) cm3.
CONCLUSIONUltrasound-guided transrectal microwave ablation of the prostate can effectively cause coagulative necrosis of the local tissue without inflicting thermal injury upon the surrounding tissues. Conventional grayscale ultrasound can give a real-time'display of the extent of thermal lesion and the whole process of the ablation.
Animals ; Catheter Ablation ; instrumentation ; methods ; Dogs ; Feasibility Studies ; Male ; Microwaves ; Prostate ; diagnostic imaging ; Rectum ; diagnostic imaging ; Ultrasonography
10.Volumes of total prostate and transitional zone are positively correlated with age in benign prostatic hyperplasia patients.
Zhi-Yong LIU ; Chuan-Liang XU ; Xu GAO ; Luo-Man ZHANG ; Xiao-Feng GAO ; Zhen-Sheng ZHANG ; Tie ZHOU ; Ying-Hao SUN
National Journal of Andrology 2008;14(12):1103-1105
OBJECTIVETo investigate the total prostate volume (TPV) and prostate transitional zone volume (TZV) in different age groups of benign prostatic hyperplasia patients, calculate the transitional zone index (TZI), and analyze correlation of age with the above parameters.
METHODSWe divided 1,563 BPH patients into 4 age groups (50-59, 60-69, 70-79 and 80-89 y), measured their TPV and TZV by rectal ultrasonography, calculated their TZI and evaluated all the data obtained by statistical analysis.
RESULTSThe TPV, TZV and TZI of the BPH patients were shown to be (32.27 +/- 15.76) ml, (9.55 +/- 98) ml and 0.28 +/- 0.13 in the 50-59 y group; (40.93 +/- 17.45) ml, (14.94 +/- 11.83) ml and 0.34 +/- 0. 16 in the 60-69 y group; (46.56 +/- 20.31) ml, (19.54 +/- 19.25) ml and 0.39 +/- 0.16 in the 70-79 y group; and (47.85 +/- 26.63) ml, (20.40 +/- 16.78) ml and 0.41 +/- 0.19 in the 80-89 y group. Both TPV and TZV were positively correlated with the patients' age, (r1 = 0.232, r2 = 0.256).
CONCLUSIONTPV and TZV increase with age in BPH patients, the latter even more obviously than the former.
Age Factors ; Aged ; Aged, 80 and over ; Humans ; Male ; Middle Aged ; Organ Size ; Prostate ; diagnostic imaging ; Prostatic Hyperplasia ; diagnostic imaging ; Ultrasonography