Kalkanli Arif, Tandogdu Zafer, Aydin Muammer, Karaca Alaettin Sener, Hazar Aydin Ismet, Balci Mustafa Bahadir Can, Aydin Memduh, Nuhoglu Baris
Department of Urology, Zonguldak State Hospital, Zonguldak, Turkey.
Northern Institute for Cancer Research, School of Medicine, Newcastle University, Newcastle, United Kingdom.
Urology. 2016 Feb;88:161-5. doi: 10.1016/j.urology.2015.11.029. Epub 2015 Dec 8.
To investigate the value of anatomic and blood-flow measurements of the prostate via ultrasound in identifying medical treatment response of patients with lower urinary tract symptoms due to benign prostatic enlargement. A secondary objective of the study was to compare transabdominal-transrectal measurements.
Male patients (age range 50-80) with lower urinary tract symptoms who applied to our outpatient clinic to be diagnosed with benign prostatic enlargement that were eligible for medical management were included in the prospective study. Patients (n = 49) were administered with tamsulosin for management. At baseline evaluation, all patients underwent International Prostate Symptom Score (IPSS), prostate-specific antigen (PSA), transabdominal and transrectal ultrasound [prostate volume (PV), post-void rezidu and intravesical prostatic protrusion (IPP)], and prostate subcapsular resistive index value measurement. Follow-ups were carried out 1 and 3 months after treatment. At these time-points, patients were assessed with IPSS and uroflowmetry.
IPP were identified to be negatively correlated with baseline Qmax values (P = .001, R = -0.485) and positively correlated with PSA (P = .013, R = 0.353) and PV (P = .003, R = 0.420). PV was related with resistive index (P = .026, R = 0.318) and PSA (P = .001, R = 0.619). Subsequent to medical treatment on the follow-ups, an overall improvement in the IPSS and Qmax was identified (P = .001). However, a negative correlation was identified in the change that occurred between IPSS and IPP (P = .004, R = -0.410). Other parameters were not correlated (P > .05) with the change in IPSS and Qmax. Transabdominal and transrectal measures were similar (P = .001).
This study has shown that increased IPP values are associated with lower response to alpha-receptor specific management. Transabdominal measurements are sufficient for the evaluation compared with transrectal measurement.
探讨经超声测量前列腺的解剖结构和血流情况在评估因良性前列腺增生导致下尿路症状患者的药物治疗反应中的价值。本研究的次要目的是比较经腹测量和经直肠测量。
本前瞻性研究纳入了年龄在50 - 80岁、因下尿路症状前来我院门诊就诊且被诊断为良性前列腺增生并适合药物治疗的男性患者。患者（n = 49）接受坦索罗辛治疗。在基线评估时，所有患者均接受国际前列腺症状评分（IPSS）、前列腺特异性抗原（PSA）、经腹和经直肠超声检查[前列腺体积（PV）、残余尿量和膀胱内前列腺突出（IPP）]以及前列腺包膜下阻力指数值测量。治疗后1个月和3个月进行随访。在这些时间点，对患者进行IPSS和尿流率测定。
发现IPP与基线Qmax值呈负相关（P = .001，R = -0.485），与PSA呈正相关（P = .013，R = 0.353），与PV呈正相关（P = .003，R = 0.420）。PV与阻力指数相关（P = .026，R = 0.318），与PSA相关（P = .001，R = 0.619）。随访药物治疗后，IPSS和Qmax总体有所改善（P = .001）。然而，IPSS与IPP之间的变化呈负相关（P = .004，R = -0.410）。其他参数与IPSS和Qmax的变化无相关性（P > .05）。经腹和经直肠测量结果相似（P = .001）。
本研究表明，IPP值升高与α受体特异性治疗反应较低有关。与经直肠测量相比，经腹测量足以进行评估。
