Department of Surgery, School of Medicine, College of Health Sciences, Makerere University, P. O. Box 7072, Kampala, Uganda.
Int Urol Nephrol. 2011 Jun;43(2):283-8. doi: 10.1007/s11255-010-9844-2. Epub 2010 Sep 17.
Advances in urological techniques in sub-Saharan Africa need to be supported with practical ancillary diagnostics. This study aimed at determining the accuracy of suprapubic ultrasonography (SPUS) relative to transrectal ultrasonography (TRUS), the current gold standard, in estimating preoperative prostate volume in a sub-Saharan African hospital.
Cross-sectional study of prospectively enrolled patients with severe lower urinary tract symptoms and histologically confirmed benign prostatic hyperplasia. The volume of the prostate was estimated using two modalities, SPUS and TRUS. Open prostatectomy was performed on all patients, and the mass of the enucleated prostate adenoma was measured directly.
Fifty patients were enrolled, with a mean age of 69 years. The mean prostate volume as determined by TRUS, SPUS, and direct measurement of enucleated prostatic tissue was 96.0, 95.9 and 83.5 mL, respectively. Prostate volume determined by SPUS correlated strongly with the TRUS measurement (ρ = 0.98, P < 0.001). The mean difference between the volume estimates by TRUS and SPUS was 0.09 mL [95% CI -2.07 to 1.89, P = 0.93], with upper and lower limits of agreement of -13.8 and +13.6 mL, respectively. Sensitivity, specificity, positive and negative predictive value for SPUS relative to TRUS for classifying patients according to the indication for TURP (prostate volume ≤80 mL) versus open prostatectomy (>80 mL) were 95% or higher. The volume of the enucleated adenoma was less than the volume estimated by ultrasonography by approximately 12.5 mL.
SPUS is accurate relative to TRUS in assessing preoperative volume of the prostate and can be used in the African context to assign patients to open prostatectomy or TURP.
撒哈拉以南非洲地区泌尿科技术的进步需要得到实用辅助诊断的支持。本研究旨在确定经耻骨超声检查（SPUS）相对于经直肠超声检查（TRUS）——目前的金标准——在估计撒哈拉以南非洲地区医院术前前列腺体积方面的准确性。
对患有严重下尿路症状和组织学证实的良性前列腺增生症的前瞻性入组患者进行横断面研究。使用两种方式，即 SPUS 和 TRUS 来估计前列腺的体积。所有患者均接受开放性前列腺切除术，并直接测量切除的前列腺腺瘤的质量。
共纳入 50 例患者，平均年龄为 69 岁。通过 TRUS、SPUS 和直接测量切除的前列腺组织，前列腺体积分别为 96.0、95.9 和 83.5mL。SPUS 确定的前列腺体积与 TRUS 测量值高度相关（ρ=0.98，P<0.001）。TRUS 和 SPUS 估计值之间的平均差异为 0.09mL[95%置信区间（CI）-2.07 至 1.89，P=0.93]，一致性界限分别为-13.8 和+13.6mL。SPUS 相对于 TRUS 用于根据 TURP（前列腺体积≤80mL）与开放性前列腺切除术（>80mL）的指征对患者进行分类的灵敏度、特异性、阳性和阴性预测值均为 95%或更高。切除的腺瘤体积比超声检查估计的体积小约 12.5mL。
SPUS 相对于 TRUS 评估术前前列腺体积是准确的，可用于非洲背景下将患者分配至开放性前列腺切除术或 TURP。
