Medikal veya cerrahi tedavi adayı benign prostat hiperplazili hastalarda prostatik rezistif indeks düzeyleri

Year 2011, Volume: 6 Issue: 3, 23 - 26, 01.08.2011

Süleyman Bulut Binhan Kağan Aktaş Tağmaç Deren Cüneyt Özden Öztuğ Adsan Ali Memiş

Abstract

Amaç: Daha önce yapılan çalışmalarda benign prostat hiperplazili BPH hastalarda power Doppler ultrasonografide prostatik rezistif indeks PRİ düzeylerinin artmış olduğu tespit edilmiştir. Gereç ve Yöntem: Bu çalışmada medikal ya da cerrahi tedavi adayı olan BPH’li hastaların PRİ düzeyleri değerlendirildi. Çalışmamıza BPH’li toplam 91 hasta dahil edildi ve üç gruba ayrıldı. Semptomları hafif olan 45 BPH hastasına medikal tedavi doksazosin 4mg/gün planlandı grup 1 . Şiddetli alt üriner sistem semptomları bulunan 28 grup 2 ve akut üriner retansiyon nedeniyle sonda takılan 18 grup 3 toplam 46 hasta cerrahi tedavi grubuna alındı. Bu üç grup klinik, laboratuvar değerleri ve PRİ düzeyleri bakımından karşılaştırıldı.Bulgular: Grup 1 ile hem grup 2 hem de 3 arasında istatistiksel olarak anlamlı fark varken, grup 2 ve 3 arasında ortalama PRİ düzeyi bakımından fark bulunmadı.Sonuç: Çalışmadan elde ettiğimiz sonuçlar, cerrahi endikasyonu bulunan BPH hastalarının medikal tedavi planlananlardan daha yüksek PRİ değerlerine sahip olduğunu göstermiştir

Keywords

Benign prostat hiperplazisi , power Doppler görüntüleme , prostatik rezistif indeks , transrektal ultrasonografi

Prostatic resistive ındex of benign prostatic hyperplasia patients candidate for surgery or medical therapy

Abstract

Objective: Prostatic resistive index PRI on power Doppler ultrasonography has been previously shown to be risen in patients with benign prostatic hyperplasia BPH . In the present study, we have evaluated PRI values of BPH patients who would be treated either surgically or medically. Materials and Methods: A total of 91 BPH patients included in our study. The patients divided into 3 groups: Group 1: Fourty five medical therapy candidates, Group 2: Twenty eight patients who had severe lower urinary tract symptoms, Group 3: Eighteen catheterized patients due to acute urinary retention. Fourty five patients in group 1 were planned to be given doxazocine 4mg daily and 46 patients in group 2 and 3 28+18=46 were considered candidates for surgery. Three groups were compared regarding clinical, laboratory data and PRI levels. Results: Statistically significant differences were observed between group 1 and both group 2 and group 3 while no difference existed between group 2 and 3.Conclusion: Our results showed that BPH patients candidate for surgery had higher PRI than medical therapy candidates

Keywords

Benign prostatic hyperplasia , power Doppler imaging , prostatic resistive index , transrectal ultrasonography

References

• McConnell JD, Barry MJ, Bruskewitz RC. Benign prostatic hyperplasia: Diagnosis and Treatment. Agency for Health Care Policy and Research. Clin Pract Guidel Quick Ref Gu- ide Clin, 8: 1-17, 1994.
• Christensen MM, Bruskewitz. RC Clinical manifestations of benign prostatic hyperplasia and indications for the- rapeutic intervention. Urol Clin North Am, 17: 509-516, 1990.
• Abrams P, Griffiths D. The assessment of prostatic obstruc- tion from urodynamic measurements and from residual urine. Br J Urol, 51: 129-134, 1979.
• Abrams P, Cardozo L, Fall M, et al. The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society. Neurourol Urodyn, 21: 167-178, 2002.
• Kojima M, Naya Y, Inoue W, et al. The American Urolo- gical Association symptom index for benign prostatic hyperplasia as a function of age. Volume and ultrasonic appearance of the prostate. J. Urol, 157: 2160-2166, 1997.
• Kojima M, Ochiai A, Naya Y, et al. Correlation of presu- med circle area ratio with intravesical obstruction in men with lower urinary tract symptoms. Urology, 50: 548-555, 1997.
• Kurita Y, Masuda H, Terada H, et al. Transition zone index as a risk factor for acute urinary retention in benign pros- tatic hyperplasia. Urology, 51: 595-600, 1998.
• Rifkin MD, Sudakoff GS, Alexander AA. Prostate: techni- ques, results, and potential applications of color Doppler US scanning. Radiology, 186: 509-513, 1993.
• Amiel GE, Slawin KM. Newer modalities of ultrasound imaging and treatment of the prostate.Urol Clin North Am, 33: 329-337, 2006.
• Nelson TR, Pretorius DH. The Doppler signal: where does it come from and what does it mean? Am J Radiol, 151: 439-447, 1988.
• Kojima M, Watanabe H, Watanabe M, et al. Preliminary results of power Doppler imaging in benign prostatic hyperplasia. Ultrasound Med Biol, 23: 1305-1309, 1997.
• Okihara K, Kojima M, Naya Y, et al. Ultrasonic power Doppler imaging for prostate cancer. A preliminary report. Tohoku J Exp Med, 182: 277-281, 1997.
• Kojima M, Ochiai A, Naya Y, et al. Doppler resistive index in benign prostatic hyperplasia: Correlation with ultraso- nic appearance of the prostate and infravesical obstructi- on. Eur Urol, 37: 436-442, 2000.
• Hayami S, Ushiyama T, Kurita Y, et al. The value of power Doppler imaging to predict the histological components of benign prostatic hyperplasia. Prostate, 53: 168-174, 2002.
• Kondo A, Narita H, Otani T, et al. Weight estimation of be- nign prostatic adenoma with urethral pressure profile. Br J Urol, 51: 290-294, 1979.
• Kojima M, Ohnishi K, Ohe H, et al. Transrectal ultrasono- tomography and urethral pressure profile in benign pros- tatic hypertrophy. Nippon Hinyokika Gakkai Zasshi, 75: 1406-1414, 1984.
• Kojima M, Watanabe H, Watanabe M, et al. Preliminary results of power Doppler imaging in benign prostatic hyperplasia. Ultrasound Med Biol, 23: 1305-1309, 1997.
• Karaköse A, Alp T, Güner ND, et al. Doppler ultrasonogra- fi ve rezistif indeksin iyi huylu prostat büyümesinin tanı ve tedavisindeki rolü. Türk Üroloji Dergisi, 36: 292-297, 2010.
• Memiş A, Özden C, Günay İ, et al. Is prostatic resistive in- dex helpful when choosing treatment option in patients with benign prostate hyperplasia? Societe Internationale d’Urologie (SIU) World Meeting On Lower Urinary Tract Dysfunction, Urology, Suppl. Vol. 74 (4A), MP-05.02, Marrakech, 2010.