Unidade de Pesquisa Urogenital, Universidade Estadual do Rio de Janeiro - UERJ, Rio de Janeiro, RJ, Brasil.
Setor de Urologia, Hospital Federal de Lagoa, Rio de Janeiro, RJ, Brasil.
Int Braz J Urol. 2021 Mar-Apr;47(2):308-321. doi: 10.1590/S1677-5538.IBJU.2020.0055.
To evaluate changes in verumontanum anatomy in patients with benign prostatic hyperplasia (BPH) who used 5-alpha reductase inhibitors (5-ARIs) and to propose an anatomical classification of the verumontanum.
We studied 86 patients with BPH and 7 patients without the disease (age under 40 years-old who underwent kidney or ureteral lithotripsy). Of the patients with BPH, 34 (mean age=67.26) had 5-ARIs use and 52 (mean age=62.69) did not use the drug. During surgeries, photographs of the seminal colliculus were taken and later, with the aid of software (Image J), the length (longitudinal diameter) and width (transverse diameter) of the verumontanum were measured in all patients. During the procedure, we evaluated the different types of verumontanum. For statistical analysis, the R-Project software was used.
In the group of patients with BPH who were taking medication (group 1), the mean measures of length and width of the verumontanum were 4.69mm and 2.94mm respectively. In the group of patients with BPH who did not use the drug (group 2), the mean diameters were 4.54mm and 3.20mm respectively. In the control group (group 3), the average length and width were 5.63mm and 4.11mm respectively. There was an increase in longitudinal and transverse measurements of the control group with an increase in body mass index (BMI) (p=0.0001 and p=0.035 respectively). In addition, there was a reduction in transverse diameter in the group of BPH using 5-ARI with increased prostate volume (p=0.010). We found five different verumontanum types: "volcano" (51.61%), "lighthouse" (24.73%), "whale tail" (12.90%), "hood" (5.38%) and "castle door" (5.38%), which we propose as an anatomical classification.
Veromontanum has smaller measurements in patients with BPH regardless of treatment. In the control group, there was an increase in verumontanum diameters with an increase in BMI. The volcano type of verumontanum was the most frequent regardless of groups and BMI.
评估患有良性前列腺增生（BPH）的患者在使用 5-α还原酶抑制剂（5-ARI）后精阜解剖结构的变化，并提出精阜的解剖分类。
我们研究了 86 例 BPH 患者和 7 例无该病（年龄小于 40 岁，因肾结石或输尿管结石行碎石术）的患者。在 BPH 患者中，34 例（平均年龄 67.26 岁）使用 5-ARI，52 例（平均年龄 62.69 岁）未使用该药物。在手术过程中，拍摄精阜的精液丘照片，然后使用软件（Image J）测量所有患者的精阜长度（纵向直径）和宽度（横向直径）。在手术过程中，我们评估了不同类型的精阜。统计分析使用 R-Project 软件。
在服用药物的 BPH 患者组（组 1）中，精阜的平均长度和宽度分别为 4.69mm 和 2.94mm。在未使用药物的 BPH 患者组（组 2）中，平均直径分别为 4.54mm 和 3.20mm。在对照组（组 3）中，平均长度和宽度分别为 5.63mm 和 4.11mm。随着体重指数（BMI）的增加，对照组的纵向和横向测量均增加（p=0.0001 和 p=0.035）。此外，随着前列腺体积的增加，使用 5-ARI 的 BPH 患者的精阜横径减小（p=0.010）。我们发现了五种不同的精阜类型：“火山”（51.61%）、“灯塔”（24.73%）、“鱼尾”（12.90%）、“帽状”（5.38%）和“城门”（5.38%），我们将其作为一种解剖分类。
无论治疗与否，BPH 患者的精阜测量值均较小。在对照组中，随着 BMI 的增加，精阜直径增加。无论组和 BMI 如何，火山型精阜是最常见的。
