Transition zone volume measurement--is it useful before surgery for benign prostatic hyperplasia?

Area of Science:

• Urology
• Medical Imaging
• Surgical Pathology

Background:

• Benign prostatic hyperplasia (BPH) affects a significant portion of the aging male population.
• Accurate preoperative assessment of prostate size is crucial for effective surgical management of BPH.
• Transrectal ultrasound (TRUS) is a common imaging modality used to evaluate prostate anatomy.

Purpose of the Study:

• To assess the correlation and equivalence between transition zone volume (TZV) measured by TRUS and the weight of prostate tissue removed during surgery for BPH.
• To determine if TRUS-based TZV can reliably predict the amount of tissue to be resected or enucleated.

Main Methods:

• This study included 168 patients diagnosed with BPH.
• Patients underwent either transurethral resection of the prostate (TURP) (n=120) or open prostatectomy (n=48).
• The resected/enucleated tissue weight was compared with the TZV determined by TRUS, with statistical analysis for correlation and agreement.

Main Results:

• Mean TZV was 25.43 mL (TURP group) and 76.1 mL (open prostatectomy group).
• Mean removed tissue weight was 22.9 g (TURP) and 73.96 g (open prostatectomy).
• A strong correlation was observed between TZV and tissue weight in both groups (r=0.878 for TURP, r=0.957 for open prostatectomy), with better agreement in the open prostatectomy group (P=0.263 vs. P=0.001 for TURP).

Conclusions:

• There is a significant correlation between prostate transition zone volume and removed tissue weight in patients undergoing surgery for BPH.
• While significant differences exist between TZV and resected weight in TURP, enucleated tissue weight in open prostatectomy shows good agreement with TZV.