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Updated: Aug 7, 2026
Ultrasonography of the Adult Male Urinary Tract for Urinary Functional Testing
Published on: August 14, 2019
Vascular resistance in the prostate evaluated by colour Doppler ultrasonography: is benign prostatic hyperplasia a
Andreas P Berger1, Wolfgang Horninger, Jasmin Bektic
1Department of Urology and Radiology, Medical University of Innsbruck, Austria. andreas.p.berger@uibk.ac.at
Insights
High prostatic vascular resistance, measured by resistive index (RI) using colour Doppler ultrasonography (CDUS), is linked to benign prostatic hyperplasia (BPH). This finding supports the role of impaired blood flow in BPH development.
Area of Science:
- Urology
- Vascular Biology
- Medical Imaging
Background:
- Benign prostatic hyperplasia (BPH) is a common condition associated with aging.
- Hypoxia, potentially caused by abnormal blood flow, may drive stromal growth in BPH.
- Assessing prostatic vascular resistance could offer insights into BPH pathogenesis.
Purpose of the Study:
- To evaluate prostatic vascular resistance and flow velocity in normal prostates, BPH, and prostate cancer using colour Doppler ultrasonography (CDUS).
- To determine if resistive index (RI) can differentiate between BPH and prostate cancer.
- To explore the relationship between vascular changes and BPH development.
Main Methods:
- Prospective evaluation of 92 men (22 normal, 45 BPH, 25 prostate cancer) using CDUS.
- Measurement of resistive index (RI) in peripheral, central, and transition zones of the prostate.
- Histological confirmation for BPH and prostate cancer diagnoses.
Main Results:
- Significantly higher mean RI in the transition zone of BPH patients (0.77) compared to normal and prostate cancer groups (0.65).
- No significant RI differences in peripheral and central zones among the groups.
- Increased arterial CDUS flow velocity in the transition zone of BPH patients.
Conclusions:
- Elevated transition zone RI (>0.75) is indicative of BPH.
- Results support the hypothesis that age-related impaired blood supply contributes to BPH.
- RI measurement alone cannot exclude prostate cancer.
Objective:
To evaluate prostatic vascular resistance by measuring the resistive index (RI), and flow velocity using colour Doppler ultrasonography (CDUS), in normal prostates and in patients with benign prostatic hyperplasia (BPH) or prostate cancer, as BPH is considered to be a result of urogenital ageing and studies suggest that hyperplasia in the stromal and glandular compartments might be induced by stromal growth secondary to hypoxia, which in turn results from abnormal blood flow patterns.
Patients, Subjects And Methods:
Ninety-two men (22 with normal prostates, 45 with BPH and 25 with prostate cancer; mean age 56 years) were prospectively evaluated by CDUS. The RI values for the peripheral, central and transition zones were assessed by one investigator. The diagnosis of BPH and prostate cancer was established from histological findings.
Results:
The mean (sd) RI in the transition zone was significantly higher only in patients with BPH, at 0.77 (0.05), vs 0.65 (0.05) in the other two groups. In the peripheral and central zones there was no significant difference in the RI among the three groups. Arterial CDUS flow velocity was increased in the transition zone of patients with BPH, but not in the peripheral and central zones.
Conclusions:
The present results support the hypothesis that an age-related impairment of blood supply to the lower urinary tract might have a role in the development of BPH. Although prostate cancer cannot be excluded by measuring RI, high RI values (>0.75) in the transition zone are indicative of BPH.
