Role of Prostate Ultrasonography to Predict The Efficacy of Bipolar Prostatectomy in Benign Prostatic Hyperplasia

Author(s):  
Ali Ibrahim ◽  
Diaaeldin Taha ◽  
Mona Talaat ◽  
Hossam Nabeeh ◽  
Tarek Abdelbaky

Abstract Background: We evaluated the role of prostatic ultrasonography to predict the clinical outcomes of Bipolar Transurethral resection of the prostate. Methods: 109 Patients complaining of lower urinary tract symptoms (LUTs) due to Benign Prostatic Hyperplasia (BPH) were evaluated preoperatively and postoperatively (at 1, 3, and 6 months) using ultrasonography (pelvi-abdominal and transrectal ), the International Prostate Symptom Score (IPSS), uroflowmetry, post-void residual urine volume (PVR), ejaculatory domain, and the erectile function domain of the International Index of Erectile Function (IIEF-ED). The safety of the procedure was assessed by Modified Clavien classification of complications.Result: There was a close correlation between residual tissue of prostate detected by ultrasonography and clinical outcomes. The prostate volume was significantly decreased postoperatively with a concomitant significant improvement of IPSS, Qmax, and PVR over six months of follow-up (P <0.001 ). 57.8 % of the cases in this study were sexually active, and there was no significant difference in the IIEF-ED score between preoperative and postoperative evaluation.Conclusion: Prostate ultrasonography has a significant predictive value as a single investigating tool to evaluate the clinical outcomes after bipolar transurethral resection of the prostate (TURP). The maximum improvement in IPSS and ultrasonographic measurements were detected at six months postoperatively.

2020 ◽  
Vol 10 (2) ◽  
pp. 15-25
Author(s):  
Amrallah A. Mohammed ◽  
Hanna M. Ibrahim ◽  
Hanna A. Atwa ◽  
Ayman Elshentenawy ◽  
Amira Elwan

AbstractBackgroundDisturbance in cell cycle regulatory genes is a common finding among many types of cancers. The aim of this study is to evaluate the role of cyclin D1 and DJ-1 in benign prostatic hyperplasia (BPH) and prostate cancer (PC).MethodThe current study enclosed 40 patients diagnosed with PC and 40 cases of BPH. The expression level of cyclin D1 and DJ-1 were evaluated by immunohistochemistry (IHC). Cyclin D1 scored depending on the percentage of stained nuclear tumor cells. While scoring of DJ-1 was based on intensity. The results were correlated with clinicopathological features and outcome.ResultsIn the PC group, cyclin D1 was detected in 95% and overexpressed in 42.5%, DJ-1 was positively stained in 85% and overexpressed in 47.5%. Meanwhile, in the BPH group, cyclin D1 was not detected and DJ-1 stained in only 2.5%. There was a statistically significant difference in Gleason score (GS), tumor stage, size, and treatment failure (p =< 0.001). In the terms of PC diagnosis prediction, although cyclin D1 was more specific (100%), DJ-1 is more sensitive than cyclin D1 (80%, 70%, respectively) (p = 0.000).ConclusionsCyclin D1 and DJ-1 may emerge as a promising way for diagnosis of PC in certain circumstances, as the presence of insufficient tissue sampling, small foci of carcinoma or benign lesions mimic PC. This is in addition to the known role of cyclin D1 and DJ-1 in PC prognosis.


2019 ◽  
Vol 9 (2) ◽  
pp. e18-e18
Author(s):  
Behzad Lotfi ◽  
Sajjad Farazhi ◽  
Mohammadreza Mohammadi Fallah ◽  
Mansour Alizadeh ◽  
Rohollah Valizadeh ◽  
...  

Introduction: Benign prostate hyperplasia, pathophysiology contributes to bladder outlet obstruction due to functional obstruction caused by gland size enlargement resulting in the lower urinary tract symptoms (LUTS). Objectives: To determine the correlation of the prostate volume with surgical outcomes and postoperative LUTS in patients with benign prostatic hyperplasia (BPH) undergoing transurethral resection of the prostate (TURP). Patients and Methods: Patients with BPH who were refractory for medical treatment enrolled in the study. Patients divided into three groups with attention to their prostate volume conducted by transabdominal ultrasonography. To evaluate patients’ LUTS, the International Prostate Symptom Score (IPSS) questionnaire was filled for all patients preoperatively and during the first and third months follow up sessions. Results: In the current study, mean age of the patients was 66.92 ± 1.08 years. Of 111 patients, eight patients (7.2%) had prostate volume less than 30 cc, 59 patients (53.2%) had prostate volume between 30-60 cc, and 44 patients (39.6%) had prostate volume more than 60 cc. During first month postoperative, mean decrease in IPSS scores in patients with prostate volume less than 30 cc, prostate volume between 30–60 cc and prostate volume more than 30 cc were 27.72 ± 3.53, 27.32 ± 3.37 and 27.45 ± 2.87, respectively. The ANOVA test showed no significant difference between the groups (P= 0.93). Mean decrease in IPSS score during third month postoperative, had no significant difference between the three groups, too (P=0.71). Symptoms alleviation observed in 94.6% and 95.5% of the patients, during first and third months follow-up, respectively. Conclusion: There was no correlation between the IPSS scores decrease and patients’ symptoms recovery and preoperative prostate volume in patients with BPH who underwent TRUP.


Medicina ◽  
2007 ◽  
Vol 43 (10) ◽  
pp. 792 ◽  
Author(s):  
Daimantas Milonas ◽  
Aivaras Matjošaitis ◽  
Mindaugas Jievaltas

Objective. The aim of this study was to estimate the equivalence and correlation between transition zone volume, measured by transrectal ultrasound, and removed prostate tissue weight in surgically treated patients due to benign prostatic hyperplasia. Material and methods. This study involved 168 patients with histologically confirmed benign prostatic hyperplasia. Of these patients, 120 underwent transurethral resection of the prostate and 48 – open prostatectomy. The weights of the specimens were compared with the corresponding volumes of the transition zone. Equivalence and correlation between transition zone volume and removed tissue weight were analyzed. Results. The mean (standard deviation, range) transition zone volume was 25.43 mL (±13.19, 5–61.6) in the transurethral resection group and 76.1 mL (±42.97, 13–275.8) in the open operation group. The mean removed tissue weight was 22.9 g (±13.41, 5–66) and 73.96 g (±44.96, 18– 280), respectively, in the transurethral resection and open operation groups. The correlation between removed tissue weight and transition zone volume was stronger in the open operation group than it was in the resection group (r=0.957, P<0.001 vs. r=0.878, P<0.001). There was a significant difference between transition zone volume and resected tissue weight (P=0.001). However, in the open operation group, there was an agreement between transition zone volume and enucleated tissue weight (P=0.263). Conclusions. A significant correlation was detected between removed tissue weight and transition zone volume. There is a significant difference between volume measurement and resected tissue weight while enucleated tissue weight was in agreement with transition zone volume when an open prostatectomy was performed.


2019 ◽  
Vol 13 (3) ◽  
pp. 69
Author(s):  
Ramlan Halimi ◽  
Achmad Rizky Herda Pratama

Background: Benign Prostatic Hyperplasia (BPH) is the most common pathological condition in man that causes Lower Urinary Tract Syndrome (LUTS). The most popular therapeutic modality for BPH is Transurethral Resection of Prostate (TURP). This study describes the TURP outcome in BPH patient with prostate size > 75 grams compared to < 75 grams in Karawang General Referral Hospital.Methods: We performed a retrospective review of clinical outcome from BPH patient with LUTS who underwent TURP procedure between January 2017 – April 2018. Data was taken through patient medical records and processed descriptively to describe complications, quality of life, and clinical laboratory data. Qualitative data compared with Chi-Square test.Results: During this study, we evaluated 40 patients, 20 patients with prostate size > 75 grams (group 1) and 20 patients with prostate size < 75 grams (group 2). Mean age in group 1 was 65.6 ± 9.9 years and in group 2 was 65.3 ± 10.2 years. International Prostate Symptom Score (IPSS) after TURP between group 1 and group 2 showed a significant difference, while incomplete emptying was found mostly in group 2 (p < 0.05). There was no significant difference in Quality of Life Score between group 1 and group 2 (p > 0.05). From laboratory results, we found a reduction of hemoglobin in both groups with p-value < 0.05 or no significant difference.Conclusions: Transurethral Resection of Prostate (TURP) procedure for patient with prostate size > 75 grams is safe and effective with lower complications and there is no significant difference compared to patient with prostate size < 75 grams.


2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Döndü Nergiz ◽  
Hülya Tosun Yıldırım ◽  
Şenay Yıldırım

Abstract Background Prostate cancer can be detected incidentally in patients undergoing transurethral resection of the prostate for benign prostatic hyperplasia. Therefore, it is very important that the transurethral resection of the prostate specimen is evaluated carefully for accurate grading and staging. The aim of this study was to investigate the frequency of incidental prostate cancer and its relationship with clinicopathological findings. Methods The study included a total of 900 patients, who underwent transurethral resection of the prostate for benign prostatic hyperplasia treatment between June 2010 and June 2020. Patient age, prostate-specific antigen (PSA) levels and resected prostate weight were assessed, and the tumor stage, Gleason grade group, lymphovascular and perineural invasion status were also evaluated in the incidental prostate cancer group. The association between these parameters and prostate cancer detection was analyzed. Results Incidental detection of prostate cancer was determined at the rate of 13.3%. The incidental prostate cancer group had a significantly higher mean age and PSA levels compared to the benign prostatic hyperplasia group. The weight of the resected specimen had no impact on the incidence of incidental prostate cancer. Of the total 120 incidental prostate cancer cases, 59 (49.2%) were stage T1a and 61 (50.8%) were stage T1b. No significant difference was determined between the T1 stages and age distribution, but a statistically significant difference was determined in the other clinicopathological parameters. Conclusions The results of this study demonstrated that the incidence of incidental prostate cancer detection was related to age and PSA levels and increased, especially in those aged ≥ 60 years and/or PSA level ≥ 4 ng/mL. To avoid overlooking incidental prostate cancer in these patients, it can be recommended that material is sufficiently sampled and carefully evaluated, and when necessary, all resected specimens are examined. Although no significant correlation was determined between specimen weight and the incidence of incidental prostate cancer, as a significant difference was determined in T1 stages, this suggests that the amount of material evaluated could change the sub-stage.


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