[The value of diagnostic imaging in benign prostatic hyperplasia and prostatic cancer]

Diseases of the prostate are of high socioeconomic importance owing to their high incidence and prevalence rates. Benign prostatic hyperplasia (BPH) can be detected in 80% of males over the age of 80. Clinical symptoms do not correlate with organ enlargement. Only 10% of patients with BPH need surgical treatment. The decision for surgical treatment is made as a result of objective findings and the symptoms reported by the patient. Preoperative evaluation of BPH must include digital rectal examination (DRE), measurement of peak flow rate, sonographic estimation of residual urine, transrectal ultrasound (TRUS), urethrocystography and the assessment of subjective complaints using symptom scores. Prostatic carcinoma is the most common malignancy in men. An abnormal DRE, increased PSA level and/or hypoechogenic lesions in TRUS are indications for prostate biopsy. The sensitivity of TRUS is superior to that of CT and MRI. New MRI techniques are promising with regard to local tumour extent. Whereas CT and MRI are not useful in screening of patients, these methods are valuable diagnostic tools in the follow-up of prostate cancer.