Comparison of Transabdominal and Transrectal Ultrasound for Sizing of the Prostate

Volume of the normal prostate gland in polish boys, aged 1-17 years: Based on transabdominal ultrasound - Prospective study

BACKGROUND

Until now, there are no established norms for prostate size in children. Prostate volume during development has been analyzed in small study groups. In diagnostic imaging, transabdominal ultrasound and magnetic resonance imaging are used.

AIMS

To establish prostate volume norms for individuals aged 1-17 years using transabdominal ultrasound.

STUDY DESIGN

Between 2021 and 2023, transabdominal prostate ultrasound was performed on 482 Caucasian boys, aged 1-17 years, who were patients of the urology clinic. Normative data were based on results of 345 boys with normal lower urinary tract, urethral and penile structures. Patients with abnormal external genitalia, Prune Belly Syndrome, Myelomeningocele, chromosomal disorders, or prostate abnormalities found in ultrasound were excluded from the study. Patient eligibility was determined based on medical records and physical examinations. During ultrasound, height, anterior-posterior dimension, and width of prostate were assessed. Prostate volume was calculated using the ellipsoid formula VH x L(AP) x W x 0.523. Measurements were correlated with age, weight, and height. Results were analyzed using descriptive statistics, statistical significance tests for means, and correlation methods. After estimating preliminary results, taking into account the development periods, patients were divided into age groups: 1-4 years (n = 70), 5-10 years (n = 124), 11-12 years (n = 43), 13-15 years (n = 65), and 16-17 years (n = 43).

RESULTS

The table and nomogram shows prostate volumes based on age. Prostate size remains stable up to the age of 8. We noticed a transitional phase at the age of 8-11 years. A significant increase in volume occurs over 11 years of age. There was a statistically significant relationship between prostate size, age, height, and weight.

DISCUSION

Established norms can serve as a reference for prostate analysis in patients with defects of the genitourinary system. An interesting analysis would be a prostate size assessment in relation to stage of development on Tanner scale.

CONCLUSION

Transabdominal ultrasound, being a non-invasive, painless, and readily accessible examination, allows assessment of prostate size even in boys aged 1 year old. A statistically significant relationship was found between prostate size, weight, and height. Norms for prostate size in boys were established according to age.

Evaluation of transabdominal and transperineal ultrasound-derived prostate specific antigen (PSA) density and clinical utility compared to MRI prostate volumes: A feasibility study

Purpose

To investigate the accuracy of surface-based ultrasound-derived PSA-density (US-PSAD) versus gold-standard MRI-PSAD as a risk-stratification tool.

Methods

Single-centre prospective study of patients undergoing MRI for suspected prostate cancer (PCa). Four combinations of US-volumes were calculated using transperineal (TP) and transabdominal (TA) views, with triplanar measurements to calculate volume and US-PSAD. Intra-class correlation coefficient (ICC) was used to compare US and MRI volumes. Categorical comparison of MRI-PSAD and US-PSAD was performed at PSAD cut-offs <0.15, 0.15–0.20, and >0.20 ng/mL² to assess agreement with MRI-PSAD risk-stratification decisions.

Results

64 men were investigated, mean age 69 years and PSA 7.0 ng/mL. 36/64 had biopsy-confirmed prostate cancer (18 Gleason 3+3, 18 Gleason ≥3+4). Mean MRI-derived gland volume was 60 mL, compared to 56 mL for TA-US, and 65 mL TP-US. ICC demonstrated good agreement for all US volumes with MRI, with highest agreement for transabdominal US, followed by combined TA/TP volumes. Risk-stratification decisions to biopsy showed concordant agreement between triplanar MRI-PSAD and ultrasound-PSAD in 86–91% and 92–95% at PSAD thresholds of >0.15 ng/mL² and >0.12 ng/mL², respectively. Decision to biopsy at threshold >0.12 ng/mL², demonstrated sensitivity ranges of 81–100%, specificity 85–100%, PPV 86–100% and NPV 83–100%. Transabdominal US provided optimal sensitivity of 100% for this clinical decision, with specificity 85%, and transperineal US provided optimal specificity of 100%, with sensitivity 87%.

Conclusion

Transperineal-US and combined TA-TP US-derived PSA density values compare well with standard MRI-derived values and could be used to provide accurate PSAD at presentation and inform the need for further investigations.

A case report of giant prostatic hyperplasia in a resource-challenged center

A benign enlargement of the prostate with weight measured above 500 gr is a rare entity that is not characterized with specific clinical findings, and requires simple open prostatectomy as the chosen management for such cases especially, in low resource context. Hereby we present a rare case of 570 gr weighted prostate hyperplasia, managed within resource-challenged hospital.

Bladder Neck Angle Associated with Lower Urinary Tract Symptoms and Urinary Flow Rate in Patients with Benign Prostatic Hyperplasia

OBJECTIVE

To evaluate the effect of the funnel-shaped structure of the bladder neck in patients with benign prostatic hyperplasia (BPH), we investigated the correlation of the bladder neck angle (BNA) with the urinary flow rate and lower urinary tract symptoms (LUTS).

METHODS

The cohort comprised 281 first-visit patients. The anatomical prostatic parameters, including BNA, total prostate volume, prostate urethral angle, intravesical prostatic protrusion, and prostate urethral length, were measured by transrectal ultrasonography. The International Prostate Symptom Score (IPSS), postvoid residual urine volume, and uroflowmetric measurements were evaluated.

RESULTS

As revealed by multivariable linear regression analysis, BNA was independently associated with the peak flow rate (Qmax) and IPSS. The mean BNA significantly differed according to the severity of prostate symptoms and Qmax, and the mean BNA was 85.5°±17.4° and 89.84°±16.31° in patients with severe prostate symptoms and a Qmax<10 ml/s (P <0.001 and <0.001, respectively). The linear regression analysis showed that BNA was positively associated with the total IPSS (R = 0.718, P <0.001) and inversely associated with Qmax (R = 0.569, P <0.001). In addition, the mean BNA in patients with acute urine residual (AUR) was higher than that in patients without AUR (86.04°±16.36° vs 63.75°±15.14°, P <0.05).

CONCLUSION

BNA is significantly correlated with LUTS and urinary flow rate in patients with BPH. Our findings suggest that BNA could play an important role in the pathogenic mechanism of BPH and AUR.