TRUS versus transabdominal ultrasound as a predictor of enucleated adenoma weight in patients with BPH: A tool for standard preoperative work-up?

• Published in: International urology and nephrology 2009-12, Vol.41 (4), p.767-771
• Main Authors: Stravodimos, Konstantinos G., Petrolekas, Andreas, Kapetanakis, Theodoros, Vourekas, Stavros, Koritsiadis, Georgios, Adamakis, Ioannis, Mitropoulos, Dionysios, Constantinides, Constantinos
• Format: Article
• Language: English
• Subjects: Abdomen - diagnostic imaging; Adenoma - diagnostic imaging; Aged; Aged, 80 and over; Diagnosis, Differential; Follow-Up Studies; Humans; Male; Medicine; Medicine & Public Health; Middle Aged; Nephrology; Organ Size; Predictive Value of Tests; Preoperative Care - methods; Preoperative Care - standards; Probability; Prostate-Specific Antigen - blood; Prostatectomy - methods; Prostatic Hyperplasia - complications; Prostatic Hyperplasia - diagnostic imaging; Prostatic Hyperplasia - surgery; Prostatic Neoplasms - diagnostic imaging; Regression Analysis; Risk Assessment; Sensitivity and Specificity; Severity of Illness Index; Treatment Outcome; Ultrasonography, Doppler - methods; Ultrasound, High-Intensity Focused, Transrectal - methods; Urinary Tract Infections - diagnosis; Urinary Tract Infections - drug therapy; Urinary Tract Infections - etiology; Urology; Urology - Original Paper
• ISSN: 0301-1623; 1573-2584
• DOI: 10.1007/s11255-009-9554-9

Background Despite being formally included in the assessment of patients presenting with lower urinary tract symptoms (LUTS), transrectal ultrasonography (TRUS) is not routinely offered to these patients. This tactic however might not be optimum since data exist on the superiority of TRUS over transabdominal ultrasound in accurately predicting prostate volumes. We aimed to evaluate TRUS as a standard tool in the evaluation of patients with benign prostate hyperplasia (BPH) with a special focus on the potential impact it might have on the decision of open versus transurethral surgery. Patients and methods Seventy-one patients presenting with LUTS due to BPH and eventually managed with open surgery based on their preference and prostate volume were included in the protocol. TRUS was performed in all patients preoperatively and calculations of the transition zone were made. These were compared with respective transabdominal calculations of the prostate volume as well as the enucleated specimen weight ( W ). Results TRUS slightly underestimated W by 4.4% (95% CI 10.5, 1.7) while transabdominal ultrasound overestimated it by 55.7% (95% CI 31.8, 79.6). Regression analysis indicated TRUS as a better predictor of W ( R 2  = 0.817, P