scholarly journals Prostate Volume Measurement by Ultrasonography Over 40 Years Age of Bangladeshi Population

2022 ◽  
Vol 8 (1) ◽  
pp. 350-356
Author(s):  
Towhida Naheen

Background: Benign prostatic hyperplasia (BPH) or benign prostatic hypertrophy, is a histologic diagnosis status characterized by proliferation of the ‘glandular elements’ of the prostate, which may lead to an enlarged prostate gland. In many studies, people over the age of 40 years found as the most vulnerable for BPH. Ultrasonography is a prominent method to determine prostate volume or size. Aim of the study: The aim of the present study was to evaluate the prostate volume measurement for the Bangladeshi population over the age of 40 years by ultrasonography.Methods:This prospective, observational study was conducted in the Department of Anatomy, Chattogram Medical College Hospital, Chattogram, Bangladesh during the period from January 2019 to December 2020. In total 157 suspected patients of benign prostatic hyperplasia were selected as the study population. All patients were clinically diagnosed for BPH, based on the present prostate symptoms and digital rectal examination. To measure the prostate volume, abdominal ultrasonography was performed for all the patients. After enucleation, another ultrasonogram was performed for all the patients to measure the existing sizes of the prostates of the patients. All the data were processed, analyzed, and disseminated by MS-word and SPSS programs as per need.Results:Finally, in this study in analyzing the volumes of the prostates of the participants according to the abdominal ultra-sonographic reports of pre-operative stage we observed, in 9%, 34%, 31%, 30%, 21% and 32% patients, the prostate sizes (In cc) were <20, 21-40, 41-60, 61-80, 81-100 and >100 cc respectively. On the other hand, after enucleation, in 11.46%, 24.20%, 28.66%, 27.39%, 7.01% and 1.27% patients, the prostate sizes (In cc) were found <20, 21-40, 41-60, 61-80, 81-100 and >100 cc respectively. The mean changes of prostate sizes between pre- and post-operative stages among the participant was not significant where the P value was found 0.464.Conclusion:The findings of this study support the applications of abdominal ultrasonographic evaluation for suspected benign prostatic hyperplasia patients to know about the exact volumes of their prostates for selecting the appropriate surgical approach.

2019 ◽  
Vol 8 (2) ◽  
pp. 92-95 ◽  
Author(s):  
Afra Samad ◽  
Nudrat Fayyaz ◽  
Ayesha Siddiqa ◽  
Naseem Akhter ◽  
Rabia Saeed ◽  
...  

Background: Pathological changes that mainly affect prostate gland are prostatitis, benign prostatic hyperplasia (BPH) and cancerous lesions. Digital rectal examination (DRE), Transrectal Ultrasonography (TUS), and prostate specific antigen (PSA) followed by histopathological examination, are routinely used tests for diagnosis of prostate lesions. The aim of the present study is to determine the role of serum PSA levels in differentially diagnosing the different types of prostate lesions.Material and Methods: This retrospective (observational) study was conducted in Ibn-e-Sina Hospital Multan. Data of 2189 patients who were operated from 2007 to 2017 due to prostatic lesions were included in this analysis. Patients with BPH, prostatitis, prostate carcinoma and Prostatic Intraepithelial Neoplasia (PIN) were grouped according to serum PSA levels (ranging from 0 to >100 ng/ml) into five groups. Frequencies and percentages were calculated for different histopathological findings. Association of PSA levels with different histological patterns was determined with chi-square test with P-value < 0.05 taken as significant difference.Results: Mean age of patients was 62.45+10.64 years. On histopathology, BPH was diagnosed in 1676 (76.56%) patients, prostatitis in 133 (6.07%), carcinoma in 378 (17.26%) and PIN in 02 (0.09%) patients, respectively. Serum PSA levels of 4.01-10 ng/ml were found in 1050 (62.64%) BPH patients and in 59 (44.36%) prostatitis patients. Serum PSA levels of 10.01-20 ng/ml were found in only 40 (2.4%) BPH patients, 47 (35.33%) prostatitis patients, 22 (5.82%) carcinoma patients and in 1 (50.0%) PIN patient. Serum PSA levels of 20.01-100 ng/ml were found in 32 (1.9%) BPH patients, 11 (8.27%) prostatitis patients, 302 (79.89%) carcinoma patients, and in 1 (50.0%) PIN patient. Serum PSA levels of >100 ng/ml were absent in patients with BPH and PIN, and present in 1 (0.75%) prostatitis and 54 (14.28%) carcinoma patients.Conclusion: Benign prostatic hyperplasia was the commonest lesion in our patients (76.56%) with serum PSA levels >10 ng/ml reported in all patients with prostate carcinoma and prostatic intraepithelial neoplasia (PIN) patients.


2017 ◽  
Vol 7 (4) ◽  
pp. 17-23
Author(s):  
Grigorij G Krivoborodov ◽  
Aleksandr P Raksha ◽  
Nikolaj S Efremov ◽  
Andrej D Bolotov ◽  
Tat'jana N Sotnikova

Relevance. Benign prostatic hyperplasia (BPH) is characterized by the presence of stromal and glandular hyperplasia in the periurethral and transitional zones. To describe the nature of intravesical growth of prostate tissue, an index of intravesical prostatic protrusion (IPP) was proposed. Clinically, men with an IPP measuring 10 mm or more are less likely to respond to α1-blocker therapy and 5α-reductase inhibitors. Thus, the description of the morphological features of the prostate depending on IPP grade is an actual issue. Purpose: to identify features of the morphological structure of the IPP in men with BPH. Materials and methods. Surgical treatment of the clinical form of BPH was performed to 30 men. Patients were divided into 2 groups: 1st group had IPP less than 10 mm (n = 12) and the 2nd group had IPP 10 mm or more (n = 18). In this study we evaluated the age, prostate volume and the value of IPP. The material for morphological investigation was obtained with transurethral resection of the prostate from the IPP zone. For light-optical examination, the preparations were stained with hematoxylin-eosin for routine evaluation of the structure of the prostate gland and for Van Gieson to estimate the proportion of the muscular and fibrous components of the stroma. The quantification of structural indicators was carried out by means of the television image analyzer MEKOS-TS2 in an automatic mode. Results: The groups were similar in age and prostate volume. In the group with IPP value of 10 mm or more, the proportion of the stromal component in the IPP zone was 77.5 ± 11.0%, the proportion of the glandular component was 22.5 ± 11.0%, respectively. In the group of men with IPP less than 10 mm, the proportion of the stromal component in the IPP zone was 96.0  1.5%, the proportion of the glandular component was 4.0 ± 1.5%, respectively (p < 0.05). It was also found that with an increase in IPP there is a tendency to decrease the proportion of the muscular component of the stroma. Conclusion: In men with BPH, with an increase in the value of intravesical prostatic protrusion in this zone, a relative increase in the proportion of the glandular component and a decrease in the proportion of the stromal component is proved, as well as a tendency to reduce the proportion of the muscular component of the stroma. (For citation: Krivoborodov GG, Raksha AP, Efremov NS, et al. Morphologic features of benign prostatic hyperplasia depending on the size of intravesical prostatic protrusion. Urologicheskie vedomosti. 2017;7(4):17-23. doi: 10.17816/uroved7417-23).


2012 ◽  
Vol 38 (1) ◽  
pp. 14-17 ◽  
Author(s):  
AKMS Hossain ◽  
AKMK Alam ◽  
AKMK Habib ◽  
MM Rashid ◽  
H Rahman ◽  
...  

The objectives of this study were to determine and compare the correlation of intravesical prostatic protrusion (IPP) and prostate volume (PV) with bladder outlet obstruction (BOO). This study was conducted in the department of urology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh, between July 2009 to September 2010. Fifty benign prostatic hyperplasia (BPH) patients were included in the study. Their evaluation consisted of history along with International Prostate Symptoms Score (IPSS), digital rectal examination (DRE), transabdominal ultrasonography to measure prostate volume, intravesical prostatic protrusion & post voidal residual (PVR) urine and pressure-flow studies to detect bladder outflow obstruction (BOO). Statistical analysis included Unpaired ‘t’ test, Chisquare test and Spearman’s Rank correlation test. Receiver Operator Characteristic (ROC) curves were used to compare the correlation of PV and IPP with BOO. Mean prostate volume was significantly larger in bladder outlet obstructed patients (P<0.05). Mean IPP was significantly greater in obstructed patients (P<0.001). Area under ROC curve was 0.700 for PV and 0.821 for IPP. Prostate volume & intravesical prostatic protrusion measured through transabdominal ultrasonography are noninvasive and accessible method that significantly correlates with bladder outlet obstruction in patients with benign prostatic hyperplasia and the correlation of IPP is much more stronger than that of prostate volume. Introduction Benign prostatic hyperplasia (BPH) is one of the most common diseases in elderly men. The prevalence of histological BPH increases with age and appears in approximately 40% of men aged 50- 60 years and in approximately 90% of men aged more than 80 years1. Benign prostatic hyperplasia may lead to prostatic enlargement, bladder outlet obstruction (BOO) and lower urinary tract symptoms (LUTS). But the symptoms and obstruction do not entirely depend on prostate’s size. In contrast, intravesical prostatic protrusion (IPP) has been found to correlate with BOO2. IPP is a morphological change due to overgrowth of prostatic median and lateral lobes into the bladder and may lead to diskinetic movement of bladder during voiding. This IPP would cause more obstruction than if there were no protrusion and just enlargement of lateral lobes, as the strong bladder contraction could force open a channel between the lobes3. Several studies have previously demonstrated that the ultrasonographic measurement of IPP is able to detect BOO in BPH patients quickly and non-invasively4. This study was designed to diagnose BOO through non-invasive methods and aimed to define the correlationDOI: http://dx.doi.org/10.3329/bmrcb.v38i1.10446  Bangladesh Med Res Counc Bull 2012; 38: 14-17


2016 ◽  
Vol 17 (1) ◽  
pp. 6-10 ◽  
Author(s):  
D Gnyawali ◽  
U Sharma

Introduction: Benign prostatic Hyperplasia is a common disorder and cause of morbidity in the ageing men. The evaluation symptoms and the bother associated with it are important for management. International Prostate Symptom Score (IPSS), Quality of life (QOL) and Benign Prostatic Hyperplasia Impact Index (BII) are practiced to quantify the severity of the disease. The size of prostate gland does not correlate with lower urinary tract symptoms. Correlation among above scoring is also not clear. Aim of the study is to evaluate correlation of prostate volume with International Prostate Symptom Score, Benign Prostatic Hyperplasia Impact Index and prostate size.Methods: Prospective study. Ninety-eight patients were included. Patients were assessed preoperatively with the International Prostate Symptom Score, Benign Prostatic Hyperplasia Impact Index and prostate volumes by trans abdominal ultrasound.Results: The mean age was 66.7  ± 7.3 years (50- 84) the mean IPSS, QOL, BII and prostate volumes were 23.6 ±6.0, 5.1 ± 0.9, 7.1±2.4 and 47.5±16.63 respectively. There was positive correlation between the IPSS and BII, IPSS and QOL and BII and  QOL (rs= 0.89, 0.585 and 0.530 respectively) and no correlation between IPSS and BII with prostatic weight. (rs= -0.04 and -0.07 respectively).Conclusion: Management of the benign prostate hyperplasia should be considered on the bother symptoms and not on the size of the prostate.Journal of Society of Surgeons of Nepal Vol.17(1) 2014: 6-10


Author(s):  
Narayanan K. J. ◽  
Kannan V. P.

Background: The aim of this prospective study is to analyse the factors influencing development of trans urethral resection of prostate (TURP) syndrome in benign Prostatic hyperplasia patients with various co morbid medical illness in Thanjavur Medical College Hospital, from February 2015 to January 2017.Methods: This prospective study was done among 38 benign hyperplasia prostate patients with various co morbid medical illness underwent TURP. Pre-operative and post-operative serum sodium levels correlated with signs and symptoms developed in various prostate gland sizes, resection times and volume of irrigation fluids.Results: Sodium level has gone down to 14 meq/L, gone up to 2 meq/L post-operatively. Major fluctuations in serum sodium was seen in prostate size more than 50 grams, resection time more than 40 mints, irrigant volume more than 24 litres. Mean sodium decrease was increased when gland size was increased, resection time was increased, irrigant volume was increased.Conclusions: In renal insufficiency patients, it is safe to complete the procedure within 40 minutes and restrict irrigant volume 15 litres, in coronary artery disease patients it is safe to restrict irrigant fluid volume less than 20 litres. In Diabetes Mellitus patients, it is safe to restrict irrigant fluid volume less than 24 litres. In hypertensive patients, it is safe to restrict the resection time less than 45 minutes. In patients with Diabetes and hypertension, it is safe to restrict the resection time less than 40 minutes and irrigant fluid less than 20 litres.


2021 ◽  
Vol 15 (6) ◽  
pp. 1888-1891
Author(s):  
Ijaz ur Rehman ◽  
Syed Atif Hussain ◽  
Humayun Khan ◽  
Bilal Habib ◽  
Raheel Sheikh

Background and Aim:Prostate histological enlargement known as Benign Prostatic Hyperplasia (BPH) is the major challenge for aging men with substantial burden on the health care system. It is associated with incomplete emptying sensations and impedance in flow due to symptoms of the lower urinary tract. Patient of higher body mass index (BMI) or obese have larger prostate volume (PV) and increase in lower urinary tract symptoms (LUTS) compared to normal BMI patient as reported by many researchers. The current study aim was to correlate the association between obesity and prostate volume in BPH patients. Materials and Methods: This cross-sectional was conducted on 140 BPH patients with 45 years to 75 years age range admitted in the department of Urology, DHQ Teaching Hospital, Dera Ismail Khan for six months duration from July 2020 to December 2020. BMI of each individual was calculated using height and weight measurements. Measuring tape was used to measure waist circumference (WC) while Prostate volume (PV) was measured with Transrectal Ultrasound (TRUS). Demographic and clinical parameters such as diabetes, smoking, prostate specific antigen (PSA) and hypertension were recorded on pre-designed proforma. Outcome variables were BMI and prostate volume. Results:Patients were divided into three categories based on BMI namely Obese, overweight and normal. Mean value for age and BMI was 61.34±5.324 and 26.89±4.13 respectively. Mean PV of Obese, overweight and normal BMI were 61.34±7.5, 59±3.10 and 50.91±8.5 cm3 respectively. The PV average score was 58.42±6.53 cm3. The mean value for waist circumference (WC) and PSA were 97.20 and 5.10±3.23 with 1.2-5.9 range respectively. The correlation between PV and BMI as well as between WC and PV, diabetes, smoking and hypertension shown no significance (p value=0.195). However, PSA and PV correlation give significant (p value 0.001-0.009) correlation. Conclusion:Central obesity plays a key role in developing and promoting BPH. The highest prevalence of BPH was found in patients with BMI >30kg/m2 while lowest in men of BMI <23 kg/m2. The current study found higher frequency of BPH among patients with WC >90 cm and lowest in men of WC <90 cm. A positive correlation was found between WC, BMI and PV. Individual quality of life affected by LUTS caused by severe risk of BPH due to increase in obesity. Balance diet and physical exercise help in maintaining the healthier BMI among obese and aged men. Keywords: Benign prostate hypertrophy, Bladder outlet obstruction, Prostate volume


2021 ◽  
pp. 16-18
Author(s):  
Arpan Yadav ◽  
Akoijam kaku Singh ◽  
Nawaz Ali

Introduction: International Prostate Symptom score (IPSS) which is identical to AUA symptom index, is recommended as a symptom scoring instrument to be used for baseline assessment of symptoms severity in men presenting with Lower Urinary Tract Symptoms.The correlation of prostate volume PV, IPP and IPSS has been extensively investigated. It was generally accepted that there was weak correlation of PV with IPSS and strong correlation of IPP with IPSS.We conducted this study to nd out whether this generally accepted correlation holds true for our patients from north east region of india Materials and Methods:This was a prospectively designed study conducted in the department of Urology, Regional institute of medical sciences imphal to To correlate lower urinary tract symptoms due to benign prostatic hyperplasia with prostate volume and intravesical prostatic protrusion. A total of 154 patients of BPH were included in the study. Statistical analysis was done by using IBM SPSS Version 21 for windows.Chi square test/scher exact test was used as a test of signicance of the study for comparing the outcome variables. P-value <0.05 was taken as signicant. Spearman correlation coefcient for categorical data and Pearson's correlation coefcient analysis for continuous variables was carried out Results and Observations:In our study maximum number of patients were in the moderate IPSS grade category 89 patients(58.00%) were having moderate symptoms,55 patients(36.0%) were having severe symptoms and 10 patients(6.0%) were having mild symptoms.There was statistically signicant and strong correlation between intraprostatic protrusion and International Prostate Symptoms Score with ('p' value <0.0001 and r =0.78). There was statistically signicant and strong correlation between Prostate volume (PV) and International Prostate Symptoms Score with ('p' value <0.001 and r =0.56). Conclusion:This study concludes that both IPP and PV have strong correlation with symptoms of BOO measured by IPSS. IPP is easy to acquire and non invasive. IPP can also helps in predicting some times the high IPSS score despite of a small prostate volume


2021 ◽  
Vol 49 (1) ◽  
pp. 030006052098628
Author(s):  
Chen Xu ◽  
Gang Zhang ◽  
Jin-jin Wang ◽  
Chun-xian Zhou ◽  
Min-jun Jiang

Objective To assess the safety and efficacy of prostatic arterial embolization (PAE) for elderly patients with lower urinary tract symptoms secondary to large benign prostatic hyperplasia. Methods Twenty-eight patients (>80 years of age) with prostate volume >80 mL were enrolled from October 2016 to October 2019. PAE was performed using microspheres and functional results were evaluated at 1, 3, 6, and 12 months postoperatively. The following data were recorded: International Prostate Symptom Score (IPSS), quality of life (QoL), maximum urine flow rate (Qmax), post-void residual urine volume, prostate volume and total prostate-specific antigen level. Results Selective prostatic arterial catheterization and embolization were achieved in 27 of 28 patients. Follow-up data were available for those 27 patients until 12 months postoperatively. Significant improvements were found at all postoperative time points in terms of the mean IPSS, mean QoL score, mean Qmax, mean post-void residual urine volume, mean total prostate-specific antigen level, and mean prostate volume. The overall complication rate was 46.4%. Conclusions PAE is an efficacious and safe treatment for elderly patients with large prostate volume; it may offer an effective approach for patients who are not candidates for open or endoscopic surgical procedures because of comorbidities.


BMC Urology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Saira Khan ◽  
K. Y. Wolin ◽  
R. Pakpahan ◽  
R. L. Grubb ◽  
G. A. Colditz ◽  
...  

Abstract Background Existing evidence suggests that there is an association between body size and prevalent Benign Prostatic Hyperplasia (BPH)-related outcomes and nocturia. However, there is limited evidence on the association between body size throughout the life-course and incident BPH-related outcomes. Methods Our study population consisted of men without histories of prostate cancer, BPH-related outcomes, or nocturia in the intervention arm of the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (PLCO) (n = 4710). Associations for body size in early- (age 20), mid- (age 50) and late-life (age ≥ 55, mean age 60.7 years) and weight change with incident BPH-related outcomes (including self-reported nocturia and physician diagnosis of BPH, digital rectal examination-estimated prostate volume ≥ 30 cc, and prostate-specific antigen [PSA] concentration > 1.4 ng/mL) were examined using Poisson regression with robust variance estimation. Results Men who were obese in late-life were 25% more likely to report nocturia (Relative Risk (RR): 1.25, 95% Confidence Interval (CI): 1.11–1.40; p-trendfor continuous BMI < 0.0001) and men who were either overweight or obese in late-life were more likely to report a prostate volume ≥ 30 cc (RRoverweight: 1.13, 95% CI 1.07–1.21; RRobese: 1.10, 95% CI 1.02–1.19; p-trendfor continuous BMI = 0.017) as compared to normal weight men. Obesity at ages 20 and 50 was similarly associated with both nocturia and prostate volume ≥ 30 cc. Considering trajectories of body size, men who were normal weight at age 20 and became overweight or obese by later-life had increased risks of nocturia (RRnormal to overweight: 1.09, 95% CI 0.98–1.22; RRnormal to obese: 1.28, 95% CI 1.10–1.47) and a prostate volume ≥ 30 cc (RRnormal to overweight: 1.12, 95% CI 1.05–1.20). Too few men were obese early in life to examine the independent effect of early-life body size. Later-life body size modified the association between physical activity and nocturia. Conclusions We found that later-life body size, independent of early-life body size, was associated with adverse BPH outcomes, suggesting that interventions to reduce body size even late in life can potentially reduce the burden of BPH-related outcomes and nocturia.


2020 ◽  
Vol 91 (4) ◽  
pp. 205-210
Author(s):  
Gian Maria Busetto ◽  
Francesco Del Giudice ◽  
Daniele D'Agostino ◽  
Daniele Romagnoli ◽  
Andrea Minervini ◽  
...  

Background: Combination therapy with 5 alpha-reductase inhibitor (5-ARI) and alpha-blocker can be considered as a gold standard intervention for medical management of lower urinary tract symptoms related to benign prostatic hyperplasia (LUTS/BPH). On the other hand, 5-ARI monotherapy and in particular Finasteride alone is currently getting focus of attention especially due to lack of systematic reviews investigating efficacy outcomes and/or adverse events associated. Objectives: Aim of the present critical review was to analyze current knowledge of clinical efficacy and incidence of adverse events associated with 5-ARI treatment for LUTS/BPH. Materials and methods: A systematic review of clinical trials of the literature of the past 20 years was performed using database from PubMed, Cochrane Collaboration and Embase. A total of 8821 patients were included in this study and inclusion criteria for studies selection were: data from randomized clinical trials (RCTs) focusing their attention on the clinical role of Finasteride monotherapy for symptomatic BPH. Parameters of research included prostate specific antigen (PSA), prostate volume (PV), International Prostate Symptom Score (IPPS), postvoid residual urine (PVR), voiding symptoms of IPSS (voiding IPSS), maximum urinary flow rate (Qmax), and adverse events (AEs). Results: Overall 12 original articles were included and critically evaluated. Sample sizes of patient actively treated with finasteride varied from 13 to 1524 cases analyzed in a single study. Follow-up after treatments ranged from 3 to 54 months. The effect of finasteride in reducing prostate volume (PV) was moderate (standardized mean difference (SMD) effect between 0.5 to 0.8 for all trials evaluable) while the effect on IPSS score and Qmax was considered significant (SMD in the 0.2 to 0.5 variation range). No severe AEs and/or psychiatric disorders were retrieved among the studies. Sexual health dysfunctions were significantly influenced by finasteride therapy when compared with placebo treated patients. Conclusions: Although significant clinical benefits of finasteride monotherapy were demonstrated, the effective size of the available reports included in the analysis is limited. Additional head-to-head studies would be needed to re-evaluate clinical efficacy and safety of 5-ARI in combination or not with alpha blockers.


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