Wyczółkowski M, Prajsner A, Piasecki Z, Pawlicki B
Oddziału Urologii Wojewódzkiego Szpitala Specjalistycznego im. Ludwika Rydygiera w Krakowie.
Wiad Lek. 2000;53(5-6):299-306.
Transrectal ultrasound (TRUS) is the popular tool in the diagnostics of benign prostatic hyperplasia (BPH) mainly visualizing the static image of prostate with closed urethra. The aim of this study was to observe the changes of the shapes and dimensions of prostatic urethra during micturition using transrectal probe, with simultaneous uroflowmetry. 174 men were examined. 58 of them (aged 20-40 y.) non obstructed--control group, 57 (aged 41-60 y.) and 59 (aged 61-80 y.) with bladder outlet obstruction (BOO) symptoms. TRUS with videorecording in upright position was done. Simultaneously uroflowmetry was performed. Maximal dimensions of the cross-sections of the prostatic urethra in sagittal plane were taken on two levels. First at the bladder neck (S1, mm), second in the middle of the prostatic urethra (S2, mm). The relations between dimensions and uroflowmetry were analyzed using also the average of the sum od S1 and S2 (S3 mm). The average dimension of S1 and S2 decreased with age from 6.3 and 7.0 mm in control group, to 5.1 and 4.5 mm in patients over the age of 60. The average of S3 decreased from 13.3 to 9.5 mm. In all groups statistically significant relations between maximal flow rate (Qmax) and S1, S2 were noted (p < 0.001 and p < 0.05). Particularly strong relations between Qmax and S3 were stated (p < 0.0001). On the base of these results the nomograms were created which allow to calculate the approximate Qmax basing on the prostatic urethra cross dimension. The TRUS measurement of the prostatic urethra cross sections during micturition allows to calculate approximately the Qmax, especially on the base of S3. The observation of the changes of the shapes and dimensions of the prostatic urethra during micturition will make easier to localize and state the character of BOO. The low Qmax with simultaneous correct cross dimensions of the prostatic urethra can suggest the detrusor insufficiency.
经直肠超声（TRUS）是诊断良性前列腺增生（BPH）的常用工具，主要用于显示尿道闭合状态下前列腺的静态图像。本研究的目的是使用经直肠探头并同步进行尿流率测定，观察排尿过程中前列腺尿道形态和尺寸的变化。对174名男性进行了检查。其中58名（年龄20 - 40岁）无梗阻——为对照组，57名（年龄41 - 60岁）和59名（年龄61 - 80岁）有膀胱出口梗阻（BOO）症状。在直立位进行带视频记录的TRUS检查。同时进行尿流率测定。在矢状面上于两个水平测量前列腺尿道横截面的最大尺寸。第一个在膀胱颈（S1，毫米），第二个在前列腺尿道中部（S2，毫米）。还使用S1和S2之和的平均值（S3毫米）分析尺寸与尿流率之间的关系。S1和S2的平均尺寸随年龄减小，对照组分别为6.3毫米和7.0毫米，60岁以上患者分别为5.1毫米和4.5毫米。S3的平均值从13.3毫米降至9.5毫米。在所有组中，均观察到最大尿流率（Qmax）与S1、S2之间具有统计学显著关系（p < 0.001和p < 0.05）。尤其发现Qmax与S3之间关系密切（p < 0.0001）。基于这些结果绘制了列线图，可根据前列腺尿道横径计算近似的Qmax。排尿过程中对前列腺尿道横截面进行TRUS测量可近似计算Qmax，尤其是基于S3。观察排尿过程中前列腺尿道形态和尺寸的变化将有助于更轻松地定位和确定BOO的特征。Qmax较低而同时前列腺尿道横径正常可能提示逼尿肌功能不全。
