Ultrasonically Determined Patterns of Enlargement in Benign Prostatic Hyperplasia

Abstract

A series of 430 men aged 40 to 79 years underwent transrectal ultrasonography (TRUS) as part of a community survey of benign prostatic hyperplasia (BPH). We describe a reproducible method of prostate volume estimation and discuss the implications of prostate dimension changes in BPH. The mean prostate and adenoma volumes for the group were 32 ml (SD 14) and 15 ml (SD 11) respectively. The antero-posterior dimension of the prostate (APD) had the strongest correlation with gland volume compared with the transverse dimension (TD) and length (L). The mean ratio of adenoma volume to prostate volume was 0.45 (SD 0.13) and this increased with increasing gland volume. There was a modest correlation between the ratio and prostate volume. BPH is characterised by a proportionally greater increase in the APD compared with L and TD and by an increasing adenoma/prostate ratio. TRUS is useful in assessing the type and extent of adenoma and prostate enlargement in BPH.

Relationship Between Age, Prostate Volume, Prostate-specific Antigen, Symptom Score and Uroflowmetry in Men with Lower Urinary Tract Symptoms

“…The three prostatic diameters were measured: transverse (T), anterio-posterior (AP) and cranio-caudal (CC). Prostate volume was calculated using the formula for a prolate ellipsoid, as described by Collins et al (16).…”

Pathophysiological relationships between lower urinary tract symptoms and the prostate do not strengthen over time

“…Since histological BPH mainly develops in the transitional zone of the prostate gland, the antero-posterior dimension may be more likely to be affected by enlargement than the transverse or longitudinal dimensions. Thus the ratio of adenoma to prostate volume may be more relevant than the individual volumes and dimensions of either the adenoma or the prostate [21]. The only variables which correlated with adenoma volume at baseline and at 3 years were the AUA symptom index, nocturia, and the number of nocturnal urinations.…”

Role of Transition Zone Index in the Prediction of Clinical Benign Prostatic Hyperplasia

“…TZ volume (TZV) differs between patients with and without BPH (3). An increase in TZV is paralleled by age (4,5). The tissue resected either by transurethral prostatectomy (TUR-P) or open surgery is the TZ.…”