Prostate Vascular Flow

Keener, Thomas S.; Winter, Thomas C.; Berger, Richard E.; Krieger, John N.; Nodell, Cynthia; Rothman, Ivan; Nghiem, Hanh V.

doi:10.2214/ajr.175.4.1751169

Cited by 23 publications

(5 citation statements)

References 23 publications

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“…It remains to be seen how our results may compare with those obtained in an older population with clinically significant disease. Second, the three quantitative parameters were imaged at a single time point immediately after ejaculation, and the time course of the effected changes, which could persist for more than 24 hours (19), was not mapped. This could be addressed by conducting serial imaging during the 1–2 hours after ejaculation or by performing repeat imaging after a longer interval.…”

Section: Discussionmentioning

confidence: 99%

“…An ultrasonographic (US) study documented that ejaculation can affect imaging results, showing that ejaculation increases blood flow to the prostate for at least 24 hours, which affected the clinical assessment of prostatitis (19). Similarly, ejaculation could effect changes in T2 and apparent diffusion coefficient (ADC) values in the prostate or in the T2- or ADC-based contrast between normal and cancerous tissue.…”

mentioning

confidence: 99%

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MR Imaging of the Prostate and Adjacent Anatomic Structures before, during, and after Ejaculation: Qualitative and Quantitative Evaluation

Medved

Sammet²,

Yousuf³

et al. 2014

Radiology

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Purpose To determine the possibility of obtaining high-quality magnetic resonance (MR) images before, during, and immediately after ejaculation and detecting measurable changes in quantitative MR imaging parameters after ejaculation. Materials and Methods In this prospective, institutional review board–approved, HIPAA-compliant study, eight young healthy volunteers (median age, 22.5 years), after providing informed consent, underwent MR imaging while masturbating to the point of ejaculation. A 1.5-T MR imaging unit was used, with an eight-channel surface coil and a dynamic single-shot fast spin-echo sequence. In addition, a quantitative MR imaging protocol that allowed calculation of T1, T2, and apparent diffusion coefficient (ADC) values was applied before and after ejaculation. Volumes of the prostate and seminal vesicles (SV) were calculated by using whole-volume segmentation on T2-weighted images, both before and after ejaculation. Pre- and postejaculation changes in quantitative MR parameters and measured volumes were evaluated by using the Wilcoxon signed rank test with Bonferroni adjustment. Results There was no significant change in prostate volumes on pre- and postejaculation images, while the SV contracted by 41% on average (median, 44.5%; P = .004). No changes before and after ejaculation were observed in T1 values or in T2 and ADC values in the central gland, while T2 and ADC values were significantly reduced in the peripheral zone by 12% and 14%, respectively (median, 13% and 14.5%, respectively; P = .004). Conclusion Successful dynamic MR imaging of ejaculation events and the ability to visualize internal sphincter closure, passage of ejaculate, and significant changes in SV volumes were demonstrated. Significant changes in peripheral zone T2 and ADC values were observed.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

MR Imaging of the Prostate and Adjacent Anatomic Structures before, during, and after Ejaculation: Qualitative and Quantitative Evaluation

Medved

Sammet²,

Yousuf³

et al. 2014

Radiology

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“…The severity of prostate texture nonhomogeneity was classified using an arbitrary Likert scale and scores of 0–3 (0 = homogeneous texture, 1 = mild, 2 = moderate and 3 = severe texture nonhomogeneity). Prostate vascularization, prostate hyperemia and arterial prostatic peak systolic velocity (APPSV) were defined based on previous studies23243637 and evaluated prior to ejaculation to avoid post-ejaculatory changes in vascular flow pattern as has been previously reported 38. Seminal vesicle ultrasound features and abnormalities were defined based on previous studies 2325333940.…”

Section: Methodsmentioning

confidence: 99%

Metabolic syndrome and prostate abnormalities in male subjects of infertile couples

et al. 2014

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No previous study has evaluated systematically the relationship between metabolic syndrome (MetS) and prostate-related symptoms and signs in young infertile men. We studied 171 (36.5 ± 8.3-years-old) males of infertile couples. MetS was defined based on the National Cholesterol Education Program Third Adult Treatment Panel. All men underwent hormonal (including total testosterone (TT) and insulin), seminal (including interleukin-8 (IL-8), seminal plasma IL-8 (sIL-8)), scrotal and transrectal ultrasound evaluations. Because we have previously assessed correlations between MetS and scrotal parameters in a larger cohort of infertile men, here, we focused on transrectal features. Prostate-related symptoms were assessed using the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) and the International Prostate Symptom Score (IPSS). Twenty-two subjects fulfilled MetS criteria. In an age-adjusted logistic ordinal model, insulin levels increased as a function of MetS components (Wald = 29.5, P < 0.0001) and showed an inverse correlation with TT (adjusted r = -0.359, P< 0.0001). No association between MetS and NIH-CPSI or IPSS scores was observed. In an age-, TT-, insulin-adjusted logistic ordinal model, an increase in number of MetS components correlated negatively with normal sperm morphology (Wald = 5.59, P< 0.02) and positively with sIL-8 levels (Wald = 4.32, P < 0.05), which is a marker of prostate inflammation, with prostate total and transitional zone volume assessed using ultrasound (Wald = 17.6 and 12.5, both P < 0.0001), with arterial peak systolic velocity (Wald = 9.57, P = 0.002), with texture nonhomogeneity (hazard ratio (HR) = 1.87 (1.05–3.33), P < 0.05), with calcification size (Wald = 3.11, P < 0.05), but not with parameters of seminal vesicle size or function. In conclusion, in males of infertile couples, MetS is positively associated with prostate enlargement, biochemical (sIL8) and ultrasound-derived signs of prostate inflammation but not with prostate-related symptoms, which suggests that MetS is a trigger for a subclinical, early-onset form of benign prostatic hyperplasia.

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“…Morgan et al [ 23 ] showed that a greater than 10% reduction in whole-gland ADC value in patients on active surveillance predicted progression to radical treatment; if such cut-offs are to be used, this needs to be considered in light of the 5% reduction in whole-gland ADC we demonstrated at day 1. Although we did not look at the question of dynamic contrast-enhanced MRI, it is possible that this may also be affected by post-ejaculatory status, with a previous ultrasound study showing that ejaculation affected the clinical assessment of prostatitis by increasing prostatic blood flow for at least 24 h [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

The longitudinal effect of ejaculation on seminal vesicle fluid volume and whole-prostate ADC as measured on prostate MRI

et al. 2017

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ObjectiveTo prospectively investigate the longitudinal effect of ejaculatory abstinence on MRI-measured seminal vesicle (SV) volume and whole-prostate ADC over consecutive days.Methods15 healthy male volunteers (mean 35.9 years, range 27–53) underwent 3-T MRI at baseline and 1, 2 and 3 days post-ejaculation. Prostate and SV volumes were derived by volume segmentation and whole-gland apparent diffusion coefficient (ADC) values calculated. A mixed-effects linear regression compared ADC values and prostate/seminal vesicle volumes in each volunteer between studies in a pairwise manner.ResultsAll subjects completed the four MRIs. Mean prostate volume was 22.45 cm3 (range 13.04–31.21 cm3), with no change between the four studies (p = 0.89–0.99). 13/15 subjects showed SV volume reduction from baseline to day 1, with group-mean decreasing from 6.45 to 4.80 cm3 (−25.6%, p < 0.001), and a significant reduction from baseline to day 2 (−18.1%, p = 0.002). There was a significant volume increase from both day 1 (+21.3%, p = 0.006) and day 2 (+10.2%, p = 0.022) to day 3 post-ejaculation. There was a significant reduction in ADC from 1.105 at baseline to 1.056 × 10−3 mm2/s at day 1 (mean −4.3%, p = 0.009).ConclusionThe longitudinal effect of ejaculation on SV volume was demonstrated. Significant reductions in SV volume and whole-gland ADC were observed post-ejaculation, supporting a 3-day period of abstinence before prostate MRI.Key Points• Seminal vesicle volume significantly reduced 24 h post-ejaculation remaining reduced at day 2 • Seminal vesicle fluid volume significantly increased from day 1 to day 3 post-ejaculation • There was a significant reduction in whole-gland prostate ADC values day 1 post-ejaculation • 3-day abstinence from ejaculation is required to ensure maximal seminal vesicle distension Electronic supplementary materialThe online version of this article (doi:10.1007/s00330-017-4905-x) contains supplementary material, which is available to authorized users.

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Prostate Vascular Flow

Cited by 23 publications

References 23 publications

MR Imaging of the Prostate and Adjacent Anatomic Structures before, during, and after Ejaculation: Qualitative and Quantitative Evaluation

MR Imaging of the Prostate and Adjacent Anatomic Structures before, during, and after Ejaculation: Qualitative and Quantitative Evaluation

Metabolic syndrome and prostate abnormalities in male subjects of infertile couples

The longitudinal effect of ejaculation on seminal vesicle fluid volume and whole-prostate ADC as measured on prostate MRI

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