The Diagnostic Value of Bladder-Wall Thickness and ARFI Elastography of Bladder Wall amongst Patients with BPH

Abstract

Objective: The present study identified bladder-wall thickness and, through the use of ARFI elastography, bladder-wall elasticity values amongst patients with benign prostate hyperplasia (BPH), then examined their relationship with the disease diagnosis and progression. Methods: The study included 60 patients with BPH (patient group) and 50 healthy volunteers (control group). All members of the patient and control groups were measured for bladder-wall thickness (BWT) and bladder-wall mean shear-wave velocity (BW mean SWV) values, as well as for uroflowmetry parameters. The patient group was divided into the sub-groups of mild-medium and severe BPH, according to the International Prostate Symptom Score (IPSS). The patient and control groups and their sub-groups were compared amongst themselves. Results: Whilst the BPH group indicated a mean wall thickness of 6.3±2 mm (range: 3- 12 mm), the control group yielded a result of 2.8±0.7 mm (range: 2-5 mm), which led to the conclusion that there was a significant difference between these groups (p<0.01). The BWmeanSWV value was 1.39±0.5 m/s (range: 0.60-2.65 m/s) for the BPH group and 1.01±0.2 m/s (range: 0.60-1.50 m/s) for the control group, and this also indicated the presence of a significant difference between the groups (p<0.01). According to the IPSS, BWT was observed to be significantly higher in the severe sub-group when compared to the mild-medium BPH group [(5.07±1 mm; range: 3-7 mm), (6.8±2 mm; range: 4-12 mm), p<0.01). Conclusions: When compared to the control group, patients with BPH showed significantly higher BWT and BWmeanSWV values; these two parameters may provide an additional method in the diagnosis of bladder outlet obstruction secondary to BPH. BWT, increasing in parallel with the severity of BPH, may be utilised in the follow-up for BPH progression.

Keywords

• Bladder-Wall Thickness
• Bladder-Wall Shear-Wave Velocity
• ARFI Elastography

Benin Prostat Hiperplazili Hastalarda Mesane Duvar Kalınlığı ve Mesane Duvar ARFI Elastografinin Tanı Değeri

Abstract

Amaç: Çalışmamızda benign prostat hiperplazili (BPH) hastalarda mesane duvar kalınlığı ve ARFI elastografi yöntemi ile mesane duvarı elastisite değerlerini saptayıp, hastalığın tanısı ve progresyonu ile ilişkisini araştırdık. Gereç ve Yöntem: Çalışmaya 60 BPH’lı hasta (Hasta grubu) ile 50 sağlıklı gönüllü (Kontrol grubu) dahil edildi. Hasta ve kontrol grubunun tamamında mesane duvar kalınlığı (MDK), mesane duvarı MDmeanSWV değerleri ve uroflovmetre parametreleri ölçüldü. Hasta grup; International Prostate Symptom Skoru’na (IPSS) göre hafif-orta ve şiddetli BPH subgruplarına ayrıldı. Hasta–kontrol gurubu ve subgruplar kendi aralarında karşılaştırıldı. Bulgular: BPH’lı grup mesane duvar kalınlığı 6.3±2 mm (3-12 mm) iken kontrol grubunda 2.8±0.7 mm (2-5 mm) olup her iki grup arasında anlamlı fark mevcuttu (p<0.001). MDmeanSWV değeri BPH’lı grupta 1.39±0.5 m/s (0.60-2.65 m/s) iken, kontrol grubunda 1.01±0.2 m/s(0.60-1.50) olup her iki grup arasında anlamlı fark mevcuttu(p<0.001). IPSS ye göre şiddetli BPH’lı grup, hafif-orta BPH grup ile karşılaştırıldığında MDK, şiddetli subgrupta anlamlı şekilde daha yüksek bulundu [sırasıyla; 5.07±1 (3-7), 6.8±2 (4- 12), p<0.01]. Sonuç: Kontrol grubuna göre BPH’lı hastalarda MDK ile birlikte MDmeanSWV elastografi değerleri belirgin yüksektir, bu iki parametre BPH’ya sekonder gelişen mesane çıkış obstrüksiyon tanısında ilave bir yöntem olabilir. BPH şiddeti ile paralel artış gösteren MDK, BPH progresyonunun takibinde kullanılabilir.

Keywords

• Mesane duvarı kalınlığı
• Mesane Duvarı Shear-Wave Velosites
• ARFI Elastografi
• Benign Prostat Hiperplazisi.

References

1. 1. Schoor RA, Canning DA, Bella RD, et al. Ultrasound diagnosis of bladder outlet obstruction in rabbits. Neurourol Urodyn 1994;13(5):559-69.
2. 2. Berry SJ, Coffey DS, Walsh PC, et al. The development of human benign prostatic hyperplasia with age. J Urol 1984;132(3):474–9.
3. 3. Thorpe A, Neal D. Benign prostatic hyperplasia. Lancet 2003;361(9366):1359–67.
4. Abrams P. In support of pressure-flow studies for evaluating men with lower urinary tract symptoms. Urology. 1994; 44(2):153-55.