Benign prostatic hyperplasia (BPH) is a familiar usually involves senile males. In recent 50 years, the incidence of BPH in China has been increasing. The morphological histology of hyperplastic prostate showed the volume enlarged and weight increase, and the hyperplastic part was mainly located in transitional zone. Researchers at home and abroad studied the tissue characteristics of hyperplastic prostate by routine and special staining coupled with computer-assisted quantitative image analysis system, and found that the proliferation was mainly occurred in interstitial tissue of prostate. The imaging examination is an important assistant method to diagnose BPH. Especially, Transrectal ultrasound and magnetic resonance imaging can displayed hyperplastic prostate more clearly.
Humans ; Magnetic Resonance Imaging ; Male ; Prostatic Hyperplasia ; diagnostic imaging ; pathology ; Rectum ; diagnostic imaging ; Ultrasonography

PURPOSE: The purpose of this study was to compare prostate volume measured by transrectal ultrasonography (TRUS) between transaxial scanning and midsagittal scanning. We tried to determine which method is superior. MATERIALS AND METHODS: A total of 968 patients who underwent TRUS for diagnosis of any diseases related to the prostate were included in this study. When measuring prostate volume by TRUS, we conducted the measurements two ways at the same time in all patients: by use of height obtained by transaxial scanning and by use of height obtained by midsagittal scanning. Prostate volume was calculated by using the ellipsoid formula ([heightxlengthxwidth]xpi/6). RESULTS: For prostate volume measured by TRUS, a paired t-test revealed a significant difference between using height obtained by transaxial scanning and that obtained by midsagittal scanning in all patients (28.5+/-10.1 g vs. 28.7+/-9.9 g, respectively, p=0.004). However, there were no significant differences in the prevalence of prostate volume more than 20 g (known benign prostatic enlargement [BPE]) between the two methods by chi-square test (90.5% [n=876], 90.8% [n=879], respectively; p=0.876). When analyzed in the same way, there were no significant differences in the prevalence of prostate volume more than 30 g (generally, high-risk BPE) between the two methods (34.5% [n=334], 36.3% [n=351], respectively; p=0.447). CONCLUSIONS: Although prostate volume by TRUS differed according to the method used to measure height, that is, transaxial or midsagittal scanning, we conclude that there are no problems in diagnosing BPE clinically by use of either of the two methods.
Adult ; Age Factors ; Aged ; Aged, 80 and over ; Humans ; Male ; Middle Aged ; Prospective Studies ; Prostate/*pathology/ultrasonography ; Prostatic Hyperplasia/*pathology/ultrasonography ; Reproducibility of Results ; Ultrasonography/methods ; Young Adult

OBJECTIVETo report our experience of ultrasound guided transperineal 6-core prostate biopsy (UG6CPB) in the diagnosis of prostate cancer (PCa).

METHODSIn a prospective study, we performed UG6CPB in 104 suspected PCa patients with tPSA more than 4 microg/L and analysed the positive rate and complications of the diagnostic approach.

RESULTSPCa was detected in 24 of the 104 patients (23%), with low grade Gleason 2 to 4 in 3 cases (12.5%), intermediate grade Gleason 5 to 7 in 15 (62.5%) and high grade Gleason 8 to 10 in the remaining 6 (25%). Complications included temporary hematuria in 5 patients (4.8%), mild postbiopsy perineal discomfort in 5 (4.8%) and fever in 4 (3.8%). TPSA > or =10 microg/L, fPSA > or = 2 microg/L, fPSA/tPSA < 0.16, PSAD > or = 0.2 and prostate volume < 40 ml were the significant influencing factors of biopsy positive rate (P < 0.05).

CONCLUSIONUG6CPB is an exact and a safe way of detecting PCa.

Biopsy, Needle ; methods ; Humans ; Male ; Perineum ; Prospective Studies ; Prostate-Specific Antigen ; blood ; Prostatic Hyperplasia ; diagnostic imaging ; pathology ; Prostatic Neoplasms ; diagnostic imaging ; pathology ; Ultrasonography

Dystrophic calcification can be defined as a calcification that occurs in degenerated or necrotic tissue. It is associated with multiple clinical conditions, such as collagen vascular diseases. It involves the deposition of calcium in soft tissues despite no generalized disturbance in the calcium or phosphorus metabolism, and this is often seen at sites of previous inflammation or damage. Potassium-titanyl phosphate (KTP) laser vaporization of the prostate is safe and relatively bloodless procedure that results in a shorter catheterization, immediate symptomatic improvement, and less severe postoperative irritative symptoms. However, longer follow-up studies or reports about complications are lacking. Here in we report a case of dystrophic calcification and stone formation on the entire bladder neck after performing KTP laser vaporization of benign prostate hyperplasia. That was treated by lithotripsy and transurethral resection.
Aged ; Calcinosis/*diagnosis/pathology ; Humans ; Lasers, Solid-State/*adverse effects ; Lithotripsy ; Male ; Prostatic Hyperplasia/*surgery ; Urinary Bladder Calculi/*diagnosis/etiology/ultrasonography ; Urinary Bladder Diseases/*diagnosis/etiology/ultrasonography

OBJECTIVETo analyze the correlation between the size of prostatic middle lobe hyperplasia and the degree of bladder outlet obstruction (BOO) in patients with benign prostatic hyperplasia (BPH).

METHODSThis study included 131 BPH patients who presented with dysuria between May 2008 and June 2010. The prostate volume and intravesical prostatic protrusion (IPP) were measured by transabdominal ultrasound, Qmax and detrusor pressure at Qmax (P(det@ Qmax)) detected by urodynamic examination, the obstruction degree and detrusor contractility judged using the LinPURR Figure, and the AG value calculated (AG = P(det@ Qmax) -2Qmax). The degrees of BOO were compared between different groups of IPP by variance analysis, and the prostate volume, IPP and AG values underwent Bivariate correlation analysis.

RESULTSIPP was highly positively correlated with BOO when it was > 10 mm (r = 0.821, P < 0.01), while PV and BOO had a lower correlation (r = 0.475, P < 0.01). There was also a high positive correlation between IPP and P(det@ Qmax) (r = 0.865, P < 0.01).

CONCLUSIONA close correlation exists between prostatic middle lobe hyperplasia and BOO, and evaluating IPP by ultrasound is a reliable method to determine the degree of BOO.

Aged ; Aged, 80 and over ; Humans ; Male ; Middle Aged ; Prostate ; diagnostic imaging ; pathology ; Prostatic Hyperplasia ; diagnosis ; diagnostic imaging ; pathology ; Ultrasonography ; Urinary Bladder Neck Obstruction ; diagnosis ; pathology ; Urodynamics

OBJECTIVETo discuss the value of grey scale ultrasonography and color Doppler of bi-planar transrectal ultrasound on the diagnosis of hyperplasia prostate gland (HPG).

METHODSOne hundred and ninety-two patients with HPG and 50 control subjects underwent abdominal ultrasound and TRUS examinations. The width (W), depth (D) and length (L) of the prostates and transitional zones were respectively measured. Each transitional zone index (TZI), i.e., the ratio of the transitional zone volume to the total prostate volume was calculated. Meanwhile, we observed the blood flow distribution in the prostates, calculated the parameters of hemodynamics such as peak systolic velocity (PSV), resistance index (RI) and pulse index (PI), and analyzed their correlations with TZI.

RESULTSThe revealing rates of cystic formation, calcium calculus and ejaculatory cyst and PSV, RI of arterial vessels in HPG were all significantly higher in the HPG patients than in the control subjects, and the revealing rates of all the above pathological changes but calcium calculus by TRUS were significantly higher than by abdominal examination. TZI of HPG was positively correlated with PSV, RI and PI.

CONCLUSIONBi-planar TRUS can clearly display the normal and pathological structure of the prostate. And PSV, RI and PI may aid in the diagnosis of HPG and the assessment of the degree of prostatic proliferation.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Humans ; Male ; Middle Aged ; Prostate ; blood supply ; diagnostic imaging ; pathology ; Prostatic Hyperplasia ; diagnostic imaging ; pathology ; Regional Blood Flow ; Ultrasonography, Doppler, Color ; methods

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

Objective: To investigate the correlation of prostatic parameters of transrectal ultrasonography with age in patients with benign prostatic hyperplasia (BPH) and the patterns of prostatic enlargement in different age groups of the patients. METHODS: We retrospectively studied the reports of transrectal ultrasonography for 1 739 outpatients with BPH from January 2010 to December 2015, who were divided into four age groups, 50－59, 60－69, 70－79, and =≥80 years. We analyzed the patterns of prostatic enlargement in different age groups. RESULTS: The transrectal ultrasonographic prostatic parameters, most significantly the transitional zone index (TZI), of the BPH patients were positively correlated with age. And the prostatic parameters were gradually increased with aging, with statistically significant differences among different age groups (P <0.05). The prostate was enlarged most quickly between 50 and 69 years of age. CONCLUSIONS There is a positive correlation between age and prostatic parameters of transrectal ultrasonography, particularly the transitional zone index, in patients with BPH, which indicates that TZI can serve as one of the best criteria in evaluating BPH. The volume of the prostate, especially that of the transitional zone, is increased with aging, reaching the peak between 50 and 69 years, which is of great significance for further study of the development and progression of BPH.
Age Factors ; Aged ; Aged, 80 and over ; Disease Progression ; Humans ; Male ; Middle Aged ; Organ Size ; Prostate ; diagnostic imaging ; pathology ; Prostatic Hyperplasia ; diagnostic imaging ; pathology ; Retrospective Studies ; Ultrasonography ; methods

OBJECTIVETo analyze and evaluate the characteristics of benign prostatic hyperplasia (BPH) on contrast-enhanced ultrasound.

METHODSForty-eight BPH patients confirmed by transrectal ultrasound-guided biopsy underwent contrast-enhanced ultrasound. Contrast pulse sequencing technique (CPS) and quantitative software-ACQ were used, and the parameters of beginning enhancement time, disappearing and transit time and peak intensity (PI) of the inner gland and outer gland were recorded and analyzed.

RESULTSThe prostate was rich with blood and enhanced significantly on contrast-enhanced ultrasound. The beginning enhancement time of the prostatic inner gland, especially the area around the urethra, was much earlier than that of the outer gland, (26.68 +/- 3.76) and (31.24 +/- 5.33) s, respectively (P = 0.000). The contrast disappeared later in the inner gland than in the outer gland, (200.68 +/- 59.40) and (157.56 +/- 50.66) s, respectively (P = 0.000). The transit time of the contrast in the inner gland was much longer than in the outer gland, (173.94 +/- 60.14) and (129.21 +/- 56.91) s, respectively (P = 0.000). PI of the inner gland was much higher than that of the outer gland, (90.45 +/- 42.19) and (65.32 +/- 25.15) dB, respectively (P = 0.000).

CONCLUSIONContrast-enhanced ultrasound makes it possible to continuously observe the blood perfusion process of BPH, and promises to be an effective means for observing the blood supply in BPH.

Aged ; Aged, 80 and over ; Humans ; Image Enhancement ; Male ; Middle Aged ; Prostate ; blood supply ; diagnostic imaging ; pathology ; Prostatic Hyperplasia ; diagnostic imaging ; Regional Blood Flow ; Reproducibility of Results ; Ultrasonography ; methods

OBJECTIVETo explore the morphotic characteristics of hypoechoic nodules in the outer gland of the prostate with benign

METHODSTwenty-two hyperplastic hypoechoic nodules in the prostatic outer gland were biopsied guided by prostatic hyperplasia. transrectal ultrasound. The hematoxylin-eosin (HE) staining and immunohistochemistry combined with computer assisted quantitative image analyses were adopted to examine the mean percentages of the area densities of stroma, epithelium, glandular lumen and smooth muscle cells.

RESULTSThe area densities of stroma, epithelium, glandular lumen and smooth muscle cells were (72.52 +/- 13.14)%, (20.57 +/- 9.01)%, (6.85 +/- 4.51)% and (24.14 +/- 6.31)%, respectively.

CONCLUSIONHyperplastic hypoechoic nodules may develop in the outer gland as well as in the inner gland of the prostate, but the mean percentages of the components are different between the two kinds of nodules.

Adult ; Aged ; Aged, 80 and over ; Biopsy ; Epithelium ; diagnostic imaging ; pathology ; Humans ; Image Processing, Computer-Assisted ; Immunohistochemistry ; Male ; Middle Aged ; Muscle, Smooth ; diagnostic imaging ; pathology ; Prostate ; diagnostic imaging ; pathology ; Prostatic Hyperplasia ; diagnostic imaging ; pathology ; Ultrasonography