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  • Title: [Functional evaluation of the prostatic urethra by means of transrectal ultrasound].
    Author: Wyczółkowski M, Prajsner A, Piasecki Z, Pawlicki B.
    Journal: Wiad Lek; 2000; 53(5-6):299-306. PubMed ID: 10983385.
    Abstract:
    Transrectal ultrasound (TRUS) is the popular tool in the diagnostics of benign prostatic hyperplasia (BPH) mainly visualizing the static image of prostate with closed urethra. The aim of this study was to observe the changes of the shapes and dimensions of prostatic urethra during micturition using transrectal probe, with simultaneous uroflowmetry. 174 men were examined. 58 of them (aged 20-40 y.) non obstructed--control group, 57 (aged 41-60 y.) and 59 (aged 61-80 y.) with bladder outlet obstruction (BOO) symptoms. TRUS with videorecording in upright position was done. Simultaneously uroflowmetry was performed. Maximal dimensions of the cross-sections of the prostatic urethra in sagittal plane were taken on two levels. First at the bladder neck (S1, mm), second in the middle of the prostatic urethra (S2, mm). The relations between dimensions and uroflowmetry were analyzed using also the average of the sum od S1 and S2 (S3 mm). The average dimension of S1 and S2 decreased with age from 6.3 and 7.0 mm in control group, to 5.1 and 4.5 mm in patients over the age of 60. The average of S3 decreased from 13.3 to 9.5 mm. In all groups statistically significant relations between maximal flow rate (Qmax) and S1, S2 were noted (p < 0.001 and p < 0.05). Particularly strong relations between Qmax and S3 were stated (p < 0.0001). On the base of these results the nomograms were created which allow to calculate the approximate Qmax basing on the prostatic urethra cross dimension. The TRUS measurement of the prostatic urethra cross sections during micturition allows to calculate approximately the Qmax, especially on the base of S3. The observation of the changes of the shapes and dimensions of the prostatic urethra during micturition will make easier to localize and state the character of BOO. The low Qmax with simultaneous correct cross dimensions of the prostatic urethra can suggest the detrusor insufficiency.
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