Abdominal or Transrectal Ultrasonographic Prostate Volume and Cystoscopic Prostatic Urethral Length Measurements to Determine the Surgical Technique for Prostatectomy in Patients with Benign Prostate Hyperplasia

Abstract

Objective We aimed to determine the most suitable technique for prostate volume (PV) measurement to decide for the most appropriate surgical approach - endoscopic or open - by establishing the relationship between imaging techniques and the resected tissue weight (RTW). Materials and Methods Sixty men aged 49-95 years with lower urinary tract symptoms, who were scheduled for transurethral resection, were enrolled. The relationship of RTW with PV determined by preoperative abdominal ultrasonography as well as transrectal ultrasonography (TRUS) performed at the table just before surgery, and prostatic urethral length (PUL) measured at the time of cystoscopy was analyzed. Two groups were established with respect to PV, (less than or equal to 75 cc and greater than 75 cc, respectively), and according to PUL (less than or equal to 2.5 cm and longer than 2.5 cm, respectively). Statistical analyses were performed between the groups to identify the best correlation between resected tissue weight and pre-surgical volume determination methods. Results The strongest correlation between RTW and prostatic volume measurements was established for the TRUS measurements (r=0.79p<0.001). The coefficients of the abdominal and transrectal ultrasonographic volume and PUL were 0.127, 0.287 and 0.219, respectively. Conclusion Determination of PV by TRUS was found to be more accurate than abdominal ultrasonographic and cystoscopic measurements. Therefore, TRUS measurement of volume on the table at the time of surgery appears to be more suitable than other methods for the selection of the most suitable surgical technique especially in case of pre-operative difficulty for deciding the most appropriate surgical approach.