Effectiveness of ultrasound in the preoperative evaluation of patients with prostatism

To avoid the disadvantages of intravenous urography (IVU) and urethrocystoscopy (UCS), we investigated prospectively their replacement by ultrasound, performed during one visit in the outpatient department, in the evaluation of patients with symptoms of prostatism. One hundred twenty patients (aged 44-89 years) were included in this study. All patients underwent two main diagnostic procedures: ultrasound of the kidneys and bladder and transrectal ultrasound of the prostate (procedure A1). This was compared with IVU and UCS (procedure A2). Following procedure A1, the main diagnoses made were benign prostatic hypertrophy in 84 patients, prostatitis in 24 patients, and prostatic cancer in 12 patients. By following procedure A2, the diagnosis was changed in 20 cases. Fourteen patients had a bladder neck sclerosis, and six had a urethral stricture. There was no relevant diagnostic difference between IVU and ultrasound of the kidneys and bladder. Ultrasound of the prostate gives better information on prostatic abnormalities than does IVU or UCS. A patient with prostatism can be screened completely during one visit at the outpatient department. Only for detection of bladder neck sclerosis and urethral strictures does UCS remain preferable.