There have been much limitations and errors in evaluating prostatic conditions by traditional radiologic methods due to its location and anatomical structure. However recent introduction and improvement of the ultrasonography have been enabled us to visualize boundary of the prostate clearly and differentiate the variable findings within the prostate. Transrectal or transurethral ultrasonography of the prostate is popular nowadays, however we performed suprapubic ultrasonography of which merits are traumatic to the patients, easy to perform and it requires no adjustments or additions to basic ultrasound equipment. In order to evaluate ultrasonogram of the prostate in patients with prostatic diseases and normal adults and compare preoperative volume of the prostate on ultrasonographic estimation with postoperative volume, 31 patients with prostatic diseases and 40 normal adults under the age 60 were studied with suprapubic ultrasonography. The results obtained were as follows. 1. On ultrasonographic picture of the prostate, normal adults showed symmetrical or triangular or elliptical appearance and there were numerous fine homogenous spots within the prostate. BPH patients showed symmetric, round or oval shapes and its margin was smooth and numerous fine spots were seen within the prostate as normal adults. The prostatic size enlarged and elevated to the bladder base. Advanced prostatic cancer patients showed dyssymmetric irregular appearance. The prostate of acute prostatitis patients resembled normal prostate but prostatic size enlarged. 2. The mean prostatic volume of normal adults on ultrasonographic estimation was 21.30+/-24.80 cm3 and there were no differences of the prostatic volume between ages. 3. The mean prostatic volume of 21 BPH patients on ultrasonographic estimation was 46.2+/-17.2 cm3 and majority patients were in 33.49-61.56 cm3. 4. Comparisonal studies between preoperative ultrasonographic prostatic volume and resected prostatic volume showed correlation coefficient 0.98 (P<0.005) and mean error rate 17.58+/-8.1%. Most cases showed preoperative prostatic volume was larger than the postoperative volume which was probably due to inadequate removal of tissue and surgical capsule. As results of the above, the suprapubic ultrasonography was helpful in differential diagnosis of the prostatic diseases and estimation of the prostatic size.
Adult ; Diagnosis, Differential ; Humans ; Prostate ; Prostatic Diseases* ; Prostatic Neoplasms ; Prostatitis ; Ultrasonography ; Urinary Bladder

We evaluated the role of prostate specific antigen(PSA), digital rectal examination(DRE) and transrectal ultrasound(TRUS) in the diagnosis of prostate cancer. Of 93 patients with pathologically proven diagnosis, 19 patients had prostate cancer and 68 patients had BPH, while remaining 6 patients had other benign prostatic disease. Among the patients with prostate cancer, 17 patients had elevated PSA level(89%) and most of their PSA levels elevated above 10ng/ml(79%), while 2 patients with stage A disease had normal PSA level. Of 26 patients whose PSA levels were between 4 and 10microgram/ml, only 2 patients had prostate cancer(7.7%). However, these patients had significantly elevated PSA density compared to others. The positive predictive value of PSA, DRE and TRUS was 27%, 44% and 40% respectively. DRE and TRUS had 56% and 58% positive predictive value in patients with elevated PSA level in contrast to 0% positive predictive value of DRE and TRUS in patients with normal PSA level. When all three methods were combined, the positive predictive value rose to 67%. Although positive predictive value of DRE and TRUS was 44 and 40 % respectively, these methods appeared to be valuable when PSA level elevated concomitantly. Our data suggest that prostate biopsy should be performed in patients with elevated PSA level above 10ng/ml and PSA density might be valuable in patients with marginal PSA level (4-10ng/ml).
Biopsy ; Diagnosis* ; Digital Rectal Examination* ; Humans ; Prostate* ; Prostate-Specific Antigen* ; Prostatic Diseases ; Prostatic Neoplasms* ; Ultrasonography*

We investigated a correlation of serum prostate specific antigen(PSA) and preoperative prostatic volume measured by transrectal ultrasonography (TRUS) in 66 patients with pathologically con- firmed benign prostatic hyperplasia (BPH), as aids in the early detection of prostate cancer and in the improvement of specificity in BPH. The preoperative serum PSA value was also measured in 18 patients with pathologically confirmed prostate cancer and 15 men without prostatic disease as normal control using Tandem-R PSA radioimmunometric assay. There was a highly significant correlation between natural logarithm transformed PSA(In PSA) and non-transformed prostatic volume by linear regression analysis(r=0.6668, p<0.0001). Given above data, we determined a volume adjusted 95th percentile upper confidence limit for n PSA as an appropriate cutoff between normal and abnormal PSA value, according to prostatic volume in BPH. In the patients with BPH and prostate cancer, sensitivity, specificity, diagnostic accuracy and positive predictive value were 94%, 72%, 68% and 48%, respectively. A statistical results by the volume-adjusted cutoff for in PSA was similar to that at 10 ng/ml as cutoff for PSA value. Above 40ml in prostatic volume, however, a false positive rate was decreased in inverse proportion to prostatic volume in BPH. In summary, the prostatic volume must be considered in BPH patients with elevated serum PSA value, negative digital rectal examination and negative TRUS of prostate. And when the volume adjusted PSA cutoff is clinically applied to BPH patients for the early detection of prostate cancer, we thought that the false positive rate can be decreased in BPH patients.
Diagnosis* ; Digital Rectal Examination ; Humans ; Linear Models ; Male ; Prostate* ; Prostatic Diseases ; Prostatic Hyperplasia* ; Prostatic Neoplasms ; Sensitivity and Specificity ; Ultrasonography*

Prostatic diseases and erectile dysfunction (ED) are common diseases in urology and andrology. Basic and clinical studies have proved that there is a close relationship between the two. This article reviews the mechanism, diagnosis and treatment of ED caused by several prostatic diseases, such as acute prostatitis, chronic prostatitis, benign prostate hyperplasia and prostate cancer.
Chronic Disease ; Erectile Dysfunction ; diagnosis ; etiology ; therapy ; Humans ; Male ; Prostatic Diseases ; complications ; Prostatic Hyperplasia ; complications ; Prostatic Neoplasms ; complications ; Prostatitis ; complications

OBJECTIVETo report 2 cases of prostatic abscess and review the current characteristics of prostatic abscess in China.

METHODSTwo cases of prostatic abscess were reported, and a meta-analysis was made of the literature from the Chinese National Knowledge Infrastructure database and Wanfang Data in recent 10 years.

RESULTSBoth the cases had a high glucose level, and one of them had received instrumental examination of the lower urinary tract prior to the problem, both with difficult defecation, severe perineal pain and high fever, with normal peripheral white blood cell count and negative urine routine. One case of abscess was confirmed by MRI, ruptured into urethra and cured by antibiotics. The other case was confirmed by transrectal ultrasound and CT and cured by transrectal ultrasound guided needle aspiration. Meta-analysis showed that the predisposed factors were diabetes mellitus, the indwelling catheter and instrumentation of the lower urinary tract. Major pathogens were staphylococci aureus and Escherichia coli. For most patients, the diagnosis was mainly established by ultrasonography and the treatment included needle aspiration or surgery.

CONCLUSIONThe clinical symptoms of prostatic abscess are not typically presented and the differential diagnosis may be difficult. Imaging investigation is helpful, and transrectal ultrasonography can be used for both diagnosis and treatment.

BACKGROUND: Prostatitis is one of the most common prostatic disease. But compared with other prostatic disease, the evaluation of the cause, diagnosis and treatment for prostatitis is not enough yet. So, this study aims to evaluate the usefulness and significance of polymerase chain reaction (PCR) in the diagnosis of prostatitis. MATERIAL AND METHODS: We evaluated the frequency of the causative orgamnism of prostatitis, i.e., C. trachomatis, T. vaginalis, M. hominis, M. genitalium and U. urealyticum, in 104 patients who visited the Department of Urology, Catholic University St. Mary's Hospital and who had prostatitis symptom from January 1999 to August 1999 by using PCR. The enrolled patients were categorized by the definition of the NIH Chronic Prostatitis Work Shop. Among 104 patients, there were Category II (chronic bacterial prostatitis) 3 patients (2.9%), Category IIIa (inflammatory chronic pelvic pain syndrome) 33 patients (31.7%) and Category IIIb (noninflammatory chronic pelvic pain syndrome) 68 patients (65.4%). RESULTS: We found out that causative microorganisms were not detected at Category II; 9 cases (27.3%) in Category IIIa-C. trachomatis 5 cases, U. urealyticum 1 case, M. genitalium 2 cases and both C. trachomatis and M. genitalium 1 case; 5 cases (7.4%) in Category IIIb-C. trachomatis 1 case, U. urealyticum 1 case, M. genitalium 1 case, both C. trachomatis and M. genitalium 1 case and both U. urealyticum and M. hominis 1 case. In a total of 17 cases of positive PCR, the common causative microorganisms were C. trachomatis (8 cases:47.1%), M. genitalium (5 cases), U. urealyticum (3 cases) and M. hominis (1 case) in this order. CONCLUSION: With the invention of PCR, the inconvenience of patients in the process of extracting causative microorganisms decreased and it became possible to get a result within 2~4 hours in technically less difficult way. Moreover, the PCR shows nearly 100% of accuracy in terms of sensitivity and specificity. Like this, it is expected that PCR will play an important role as a way of diagnosis and treatment for prostatitis.
Diagnosis ; Humans ; Inventions ; Pelvic Pain ; Polymerase Chain Reaction* ; Prostatic Diseases ; Prostatitis* ; Sensitivity and Specificity ; Urology

Carcinoembryonic antigen (CEA) levels were measured in the serum of 35 normal control group and 200 urologic cases of tumor and non-tumor groups at the Department of Urology, National Medical Center during the period from November, 1981 to June, 1983. The following results were obtained: 1. Mean serum CEA level in normal control subjects was 3.2 +/- 2.4 ng/ml. 2. Incidence of positive results and mean serum CEA levels in each groups of disease were as follows: 15 of 30 cases (50%) and 30.0 ng/ml in tumor group, 9 of 30 cases (30.0%) and 9.6 ng/ml in benign prostatic hyperplasia, 13 of 55 cases (23.6%) and 7.4 ng/ml in calculous disease group, 5 of 30 cases (16.7%) and 12.8 ng/ml in infectious disease group, 3 of 26 cases ( 11.5%) and 4.6 ng/ml in congenital anomaly group, I of 14 cases (7.1%) and 4.1 ng/ml in injury group. 3. Incidence of positive results and mean serum CEA levels in each tumor were as follows: 9 of 14 cases (64.3%) and 44.6 ng/ml in bladder tumor, 3 of 3 cases (100%) and 33.7 ng/ml in prostate cancer, 1 of 4 cases (25%) and 8.0 ng/ml in renal cell carcinoma, 1 of 2 cases and 13.0 ng/ml in testis tumor, 1 of 1 case and 84.0 ng/ml in renal pelvis tumor. 4. Mostly the frequency of abnormal serum CEA values correlated with the grade and stage of bladder tumor. 5. The raised serum CEA levels declined to normal early in the postoperative period in the tumor and non-tumor groups if adequate surgery had been effected. 6. Due to low positive result in tumor group (50%) and relatively high positive results in non-tumor groups (20.5%), serum CEA values were of little value in the diagnosis of genitourinary tract tumor.
Carcinoembryonic Antigen ; Carcinoma, Renal Cell ; Communicable Diseases ; Diagnosis ; Incidence ; Kidney Pelvis ; Postoperative Period ; Prostatic Hyperplasia ; Prostatic Neoplasms ; Testis ; Urinary Bladder Neoplasms ; Urologic Diseases* ; Urology

Carcinoembryonic antigen (CEA) levels were measured in the serum of 35 normal control group and 200 urologic cases of tumor and non-tumor groups at the Department of Urology, National Medical Center during the period from November, 1981 to June, 1983. The following results were obtained: 1. Mean serum CEA level in normal control subjects was 3.2 +/- 2.4 ng/ml. 2. Incidence of positive results and mean serum CEA levels in each groups of disease were as follows: 15 of 30 cases (50%) and 30.0 ng/ml in tumor group, 9 of 30 cases (30.0%) and 9.6 ng/ml in benign prostatic hyperplasia, 13 of 55 cases (23.6%) and 7.4 ng/ml in calculous disease group, 5 of 30 cases (16.7%) and 12.8 ng/ml in infectious disease group, 3 of 26 cases ( 11.5%) and 4.6 ng/ml in congenital anomaly group, I of 14 cases (7.1%) and 4.1 ng/ml in injury group. 3. Incidence of positive results and mean serum CEA levels in each tumor were as follows: 9 of 14 cases (64.3%) and 44.6 ng/ml in bladder tumor, 3 of 3 cases (100%) and 33.7 ng/ml in prostate cancer, 1 of 4 cases (25%) and 8.0 ng/ml in renal cell carcinoma, 1 of 2 cases and 13.0 ng/ml in testis tumor, 1 of 1 case and 84.0 ng/ml in renal pelvis tumor. 4. Mostly the frequency of abnormal serum CEA values correlated with the grade and stage of bladder tumor. 5. The raised serum CEA levels declined to normal early in the postoperative period in the tumor and non-tumor groups if adequate surgery had been effected. 6. Due to low positive result in tumor group (50%) and relatively high positive results in non-tumor groups (20.5%), serum CEA values were of little value in the diagnosis of genitourinary tract tumor.
Carcinoembryonic Antigen ; Carcinoma, Renal Cell ; Communicable Diseases ; Diagnosis ; Incidence ; Kidney Pelvis ; Postoperative Period ; Prostatic Hyperplasia ; Prostatic Neoplasms ; Testis ; Urinary Bladder Neoplasms ; Urologic Diseases* ; Urology

BACKGROUND: The prostate-specific antigen (PSA) is considered the most useful among tumor markers currently used. However, its quantitative results are interpreted only qualitatively for the diagnosis of prostate cancer. The recently introduced information theory enables the information of the quantitative results transformed into Shannon's entropy (S) that represents uncertainties and then "1-S" representing diagnostic certainty. METHODS: The 882 urological patients enrolled were categorized into 2 groups: a patient group comprising 233 patients with prostate cancer and a disease control group comprising 649 patients with benign prostate disease. The level of PSA in all the patients was tested and was found to be > or =2 ng/mL. The variables like PSA level and age were modeled on logistic regression analysis to predict the probability of prostate cancer and the diagnostic certainty. RESULTS: The mean (SD) of PSA levels in the patient group and the disease control group were 44.5 ng/mL (37.62 ng/mL) and 5.7 ng/mL (3.70 ng/mL), respectively. The logistic regression model fitted well when the age variable was dichotomized at the age of 55 yr. The diagnostic certainty was lowest at a PSA level of 18.90 ng/mL in the <55-yr age group, and 15.45 ng/mL in the >55-yr age group. CONCLUSIONS: The diagnostic certainty (1-S) of whether to diagnose prostate cancer or not at a certain PSA level could be obtained using the information theory. The methodology used in this study may help interpret the results of other quantitative tests.
Age Factors ; Aged ; Entropy ; Humans ; *Information Theory ; Logistic Models ; Male ; Middle Aged ; Prostate-Specific Antigen/*blood ; Prostatic Diseases/diagnosis ; Prostatic Neoplasms/*diagnosis

Histopathological studies with clinical observation were made on 41 patients performing the prostatic needle biopsy for the purpose of detecting occult early cancer of the prostate in geriatric patients and tuberculosis of the prostate in young age groups in the department of Urology, Jeonbug National University, medical school from January, 1980. The results were as follows; 1. The most prevalent age was from 60 to 79 (76%). 2. Of 41 cases performing prostatic needle biopsy, 36 cases were transperineal route and 5 cases were transrectal route. 3. Among 38 cases of adequate tissues obtained by prostatic needle biopsy, 3 cases were diagnosed as adenocarcinoma of the prostate. 4. Complications after the prostatic needle biopsy developed in 4 cases, including rectal hemorrhage in 1 case, fever in 1 case and perineal pain in 2 cases. 5. Of 41 cases performing the prostatic needle biopsy, TURP in 30 cases, Trocar cystostomy in 7 cases and conservative therapy in 4 cases were performed. 6. Of 30 cases performing TURP, B.P.H. in 27 cases and adenocarcinoma of the prostate in 3 cases were proved by histological study. 7. Of 41 cases performing the prostatic needle biopsy, 7 cages had associated diseases besides various prostatic diseases and were performed Trocar cystostomy.
Adenocarcinoma ; Biopsy, Needle* ; Cystostomy ; Diagnosis ; Fever ; Hemorrhage ; Humans ; Jeollabuk-do ; Needles* ; Prostate ; Prostatic Diseases ; Prostatic Neoplasms ; Schools, Medical ; Surgical Instruments ; Transurethral Resection of Prostate ; Tuberculosis ; Urology