Does digital rectal examination predict prostate volume greater than 30 mL?

Area of Science:

• Urology
• Diagnostic Imaging
• Men's Health

Background:

• Lower urinary tract symptoms (LUTS) are common in men, often associated with benign prostatic hyperplasia (BPH).
• Accurate prostate volume estimation is crucial for BPH management.
• Digital rectal examination (DRE) is a standard clinical assessment, but its accuracy in estimating prostate volume requires further investigation.

Purpose of the Study:

• To evaluate the accuracy of digital rectal examination (DRE) in estimating prostate volume.
• To compare DRE findings with transrectal ultrasound (TRUS) measurements in patients with LUTS suggestive of BPH.

Main Methods:

• A community-based study in Japan included 457 men with LUTS.
• Prostate volume was measured using transrectal ultrasound (TRUS).
• DRE findings were categorized into five groups: flat, normal, slightly enlarged, moderately enlarged, and markedly enlarged.

Main Results:

• Median prostate volume was 19.7 mL in men aged 64 years.
• Significant differences in prostate volume were observed across DRE categories (e.g., flat: 16.4 mL, markedly enlarged: 86.3 mL).
• DRE showed high accuracy in classifying prostates as <30 mL (flat/normal group, 94.1% PPV) or ≥30 mL (moderately/markedly enlarged group, 80.8% PPV).

Conclusions:

• Digital rectal examination (DRE) can effectively stratify prostate volume.
• DRE reliably identifies prostates <30 mL and ≥30 mL, aiding in BPH assessment.
• Transrectal ultrasound (TRUS) remains necessary for precise volume determination in the 'slightly enlarged' DRE category.