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 ; Male ; Prostatic Hyperplasia/diagnostic imaging* ; Prostate/diagnostic imaging* ; Clinical Relevance ; Hyperplasia ; Lower Urinary Tract Symptoms/complications* ; Calcinosis/diagnostic imaging*

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

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

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

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

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

OBJECTIVETo analyze the correlation of the length and volume of intravesical prostatic protrusion (IPP) with bladder outflow obstruction (BOO) in patients with BPH and to find a simple method for the diagnosis of the disease.

METHODThe length and volume IPP were measured by transrectal ultrasound for 87 patients with BPH, the diagnosis of BOO was made by urodynamic tests and the correlation of the length and volume of IPP with BOO was analyzed, and reanalyzed 3 months after oral medication of a-blocker. The length and volume of IPP were measured again during the operation in 54 of the cases to confirm the ultrasound findings.

RESULTSBOO was diagnosed in 51 of the patients. The coefficient of correlation between the length of IPP and BOO and that between the volume of IPP and BOO were 0.53 and 0.47 (P < 0.01). Not considering the dynamic factors, they were 0.69 and 0.62 (P < 0.01), respectively. BOO was confirmed in patients with the length of IPP > 1.0 cm or the volume > 1.5 ml. There was no significant difference between the results of transrectal ultrasound and the findings during the operation concerning the length and volume of IPP (P > 0.05).

CONCLUSIONThere is a close correlation between the length and volume of IPP and BOO, which can be conveniently applied to the diagnosis of BOO in BPH patients.

Aged ; Humans ; Male ; Middle Aged ; Prostate ; diagnostic imaging ; Prostatic Hyperplasia ; complications ; diagnostic imaging ; Ultrasonography ; Urinary Bladder ; diagnostic imaging ; Urinary Bladder Neck Obstruction ; diagnosis ; etiology ; physiopathology ; Urodynamics

OBJECTIVETo investigate the correlation of the degrees of intravesical prostatic protrusion (IPP) measured by transabdominal ultrasound with the clinical evaluation parameters in BPH patients.

METHODSWe measured the length of IPP in the mid-sagittal section by transabdominal ultrasound in 275 BPH outpatients with lower urinary tract symptoms, and analyzed the correlations of the degree of IPP with the age, prostatic volume (PV), international prostatic symptom score (IPSS), maximum uroflow rate (Qmax), and postvoid residual urine volume (PVR) of the patients.

RESULTSThe degree of IPP was correlated positively with the age (r = 0.210, P < 0.01), PV (r = 0.534, P < 0.01) and PVR (r = 0.314, P < 0.01), but negatively with the Qmax (r = -0.364, P < 0.01) of the BPH patients. There was no significant correlation between the degree of IPP and IPSS (r = 0.064, P = 0.299).

CONCLUSIONThe degree of IPP may be associated with the age and prostatic volume of BPH patients. Transabdominal ultrasound measurement of IPP is a useful noninvasive method to assess the presence and severity of bladder outlet obstruction in BPH patients.

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

OBJECTIVETo investigate the prevalence of lower urinary tract symptoms (LUTS) and the age-related growth pattern of the prostate among 40 -70 year-old males in Shanghai community.

METHODSUsing cluster and stratified random sampling and IPSS, we investigated the prevalence of LUTS among 1000 males aged 40 -70 years in the general population of Shanghai from November 2009 to June 2010. We measured the transverse, anteroposterior and vertical diameters of the prostate and its transition zone in each volunteer by transrectal ultrasonography and established the equation for the age-related growth pattern of the prostate.

RESULTSIn the 40 to 49-, 50 to 59- and 60 to 70-year groups, the incidence rates of moderate and severe LUTS (IPSS > or = 8) were 10.0%, 15.0% and 28.7%, respectively. The length, width, height and volume of the prostate and its transition zone were positively corrected with age (P < 0.05). The prostatic growth pattern equations based on the parameters of the transverse, anteroposterior and vertical diameters were Y = 1.6 x 10(-5)X3-0.002 1X2 + 0.074 6X + 0.677 2, Y = -2.4 x 10(-5)X3 + 0.003 3X2-0.1312X + 1.269, and Y = 1.6 x 10(-5)X3-0.001 8X2 + 0.073X- 0.690 9, respectively. The transverse and anteroposterior diameters of the prostate grew at a relatively similar rate, while the transverse diameter grew obviously faster than the vertical diameter before 60 years old, but the latter significantly increased and even exceeded the former after 60 years old.

CONCLUSIONThe prevalence of LUTS among old and middle-aged males in Shanghai community is similar to that recently reported at home and abroad. The transverse and anteroposterior diameters of the prostate grow at a relatively similar rate, but the vertical diameter increases faster after 60 years old.

Adult ; Aged ; China ; epidemiology ; Humans ; Lower Urinary Tract Symptoms ; diagnostic imaging ; epidemiology ; Male ; Middle Aged ; Prevalence ; Prostate ; diagnostic imaging ; Prostatic Hyperplasia ; diagnostic imaging ; epidemiology ; Ultrasonography

OBJECTIVETo study significance and limitations of the ratio of free to total prostate specific antigen (f/t PSA) in differential diagnosis between prostate cancer and benign prostatehyperplasia (BPH) with total PSA (tPSA) levels between 4 and 10 ng/ml.

METHODSWe analysed retrospectively 180 prostate cancer and BPH patients who were diagnosed and treated in our hospital from October 1998 to October 2002 and had serum tPSA levels between 4 and 10 ng/ml. Of the 180 patients, 36 (20%) were histologically confirmed as prostate cancer and 144 (80%) BPH. The tPSA and free PSA (fPSA) in serum were measured by micropartical enzyme immunoassay. Prostate volume was measured by transabdominal ultrasonography. We chose Student's t-test for comparison between prostate cancer and BPH groups. The correlation between prostate volume and f/t PSA was analyzed using Pearson's correlation coefficient.

RESULTSThe mean values of tPSA and f/t PSA were 6.75 ng/ml and 0.17 in patients with prostate cancer, 6.48 ng/ml and 0.25 in patients with BPH. The mean value of tPSA wasn't significantly different between patients with prostate cancer and BPH (P > 0.05). However, the mean value of f/t PSA of patients with prostate cancer was significantly lower than that of patients with BPH (P < 0.01). Furthermore, there were significant and positive correlation between prostate volume and f/t PSA in both groups with prostate cancer and BPH (prostate cancer group's correlation coefficient (r = 0.50, P < 0.01); BPH group (r = 0.24, P < 0.01). There was significant difference in f/t PSA between prostate cancer and BPH patients with prostate volumes more than 40 cm(3) (P < 0.05), but not between these two groups with prostate volumes more than 40 cm(3) (P > 0.05).

CONCLUSIONThe f/t PSA is significant in differential diagnosis between prostate cancer and BPH with tPSA levels between 4 and 10 ng/ml. But prostate volume has an effect on f/tPSA. The f/tPSA has diagnostic value of differentiation only when the prostate volume is less than 40 cm(3).

Aged ; Aged, 80 and over ; Biomarkers, Tumor ; blood ; Diagnosis, Differential ; Humans ; Kidney ; diagnostic imaging ; Male ; Middle Aged ; Prostate-Specific Antigen ; blood ; Prostatic Hyperplasia ; diagnosis ; diagnostic imaging ; Prostatic Neoplasms ; diagnosis ; diagnostic imaging ; Retrospective Studies ; Sensitivity and Specificity ; Ultrasonography