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

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

OBJECTIVESTo study residual fraction (RF) in the bladder outlet obstruction (BOO) resulting from benign prostatic hyperplasia (BPH).

METHODSFifty adult outpatients with BPH were evaluated. With ultrasound and uroflowmetry, prevoid volume (PV) and postvoid residual volume (PRV) and peak flow rate (Qmax) were determined. Linear dependence analysis of RF and Qmax, PRV and Qmax were conducted.

RESULTSThe coefficient between RF and Qmax showed extremely negative correlation(r = -0.3859, P < 0.01). Also, PRV and Qmax showed significant negative correlation (r = -0.2831, P < 0.05).

CONCLUSIONSThe greater the RF, the more serious the BOO, the poorer potency of bladder. It is recommended that RF be used as a good supplement to PVR in the routine non-invasive evaluation of BOO caused by BPH.

Aged ; Aged, 80 and over ; Humans ; Male ; Middle Aged ; Predictive Value of Tests ; Prostatic Hyperplasia ; complications ; physiopathology ; Ultrasonography ; Urinary Bladder Neck Obstruction ; diagnostic imaging ; etiology ; physiopathology ; Urodynamics

PURPOSE: To assess the impact of intravesical prostatic protrusion (IPP) on the outcomes of robot-assisted laparoscopic prostatectomy (RALP). MATERIALS AND METHODS: The medical records of 1094 men who underwent RALP from January 2007 to March 2013 were analyzed using our database to identify 641 additional men without IPP (non-IPP group). We excluded 259 patients who presented insufficient data and 14 patients who did not have an MRI image. We compared the following parameters: preoperative transrectal ultrasound, prostate specific antigen (PSA), clinicopathologic characteristics, intraoperative characteristics, postoperative oncologic characteristics, minor and major postoperative complications, and continence until postoperative 1 year. IPP grade was stratified by grade into three groups: Grade 1 (IPP≤5 mm), Grade 2 (5 mm10 mm). RESULTS: Of the 821 patients who underwent RALP, 557 (67.8%) experienced continence at postoperative 3 months, 681 (82.9%) at 6 months, and 757 (92.2%) at 12 months. According to IPP grade, there were significant differences in recovering full continence at postoperative 3 months, 6 months, and 12 months (p<0.001). On multivariate analysis, IPP was the most powerful predictor of postoperative continence in patients who underwent RALP (p<0.001). Using a generalized estimating equation model, IPP also was shown to be the most powerful independent variable for postoperative continence in patients who underwent RALP (p<0.001). CONCLUSION: Patients with low-grade IPP have significantly higher chances of recovering full continence. Therefore, the known IPP grade will be helpful during consultations with patients before RALP.
Aged, 80 and over ; Humans ; Laparoscopy/methods ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Multivariate Analysis ; Postoperative Complications/etiology ; Prostatectomy/*methods ; Prostatic Neoplasms/complications/*surgery ; *Recovery of Function ; *Robotic Surgical Procedures ; Urinary Bladder Neck Obstruction/*diagnostic imaging/etiology ; *Urination

INTRODUCTIONThe objective of this study was to evaluate the accuracy of using intravesical prostatic protrusion (IPP) as a parameter for the diagnosis of prostate adenoma (PA), as well as to determine the relationship between the site of PA and bladder outlet obstruction. IPP was determined with the use of transabdominal ultrasonography (TAUS).

METHODSA total of 77 consecutive adult men aged 30-85 years with haematuria or undergoing checkup for bladder tumour were enrolled. International Prostate Symptom Score (IPSS), and the results of uroflowmetry, TAUS and cystourethroscopy were assessed. All cases of IPP were classified into grades 0 (no IPP), 1 (1-5 mm), 2 (6-10 mm) or 3 (> 10 mm). PA diagnosis was confirmed using flexible cystourethroscopy. The sites of PA were classified as U0 (no adenoma), U1 (lateral lobes), U2 (middle lobe) or U3 (lateral and middle lobes).

RESULTSOf the 77 patients, 11 (14.3%) had no IPP. PA was confirmed using cystourethroscopy for all patients with IPP and for 7 of the 11 patients without IPP. Of the 37 patients with prostate volume < 20 g, 29 (78.4%) had IPP. Sensitivity, specificity, as well as positive and negative predictive values for diagnosing PA using only IPP were 90.4%, 100.0%, 100.0% and 36.4%, respectively. Higher sensitivity (95.9%) and negative predictive value (50.0%) were obtained when PA was used together with peak urinary flow rate (Qmax) < 20.0 mL/s. The mean Qmax of patients classified as U1 (n = 39) was 16.0 mL/s, while the mean Qmax in those classified as U2 (n = 12) and U3 (n = 22) was 11.9 mL/s and 8.9 mL/s, respectively.

CONCLUSIONAll patients with IPP had PA, and PA in the middle lobe was more obstructive than those in lateral lobes. Patients without IPP may still have PA.

Adult ; Aged ; Aged, 80 and over ; Biopsy ; Cystoscopy ; Diagnosis, Differential ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Prospective Studies ; Prostate ; diagnostic imaging ; pathology ; Prostatic Hyperplasia ; complications ; diagnosis ; Ultrasonography ; Urinary Bladder Neck Obstruction ; diagnosis ; etiology