Category: Basic Science: BPH/LUTS

MP3-2 - Is Transrectal ultrasound the gold-standard for prostate volume estimation in men of African descent who generally have a higher mean prostate volume than other races?

Thu, Sep 20
4:00 PM - 6:00 PM

Introduction & Objective : Accurate prostate volume determination is essential for successful management of benign prostate enlargement (BPE). Though trans-rectal ultrasound (TRUS) is believed to be the gold-standard for prostate volume estimation, there are conflicting reports regarding its accuracy in men of African descent who generally have higher prostate volumes than other races. This study aimed to evaluate the accuracy of TRUS for prostate volume estimation in a cohort of African men with BPE.


Methods : Men with symptomatic BPE who had open simple prostatectomy in a university teaching hospital in south-western Nigeria between June 2014 and May 2016 were prospectively studied. TRUS was used pre-operatively to determine both total prostate volume (TPV) and transitional zone volume (TZV). The prostate specimen enucleated at surgery was weighed to obtain the enucleated prostate weight (EPW). TRUS was repeated 6-weeks post-operatively by same sonologist to obtain the residual prostate volume. This residual prostate volume was subtracted from pre-operative TPV to obtain the TRUS estimated volume of the enucleated specimen (VES). Data analysis was done using Stata 13.1 software.


Results : Seventy-seven men with mean age 69.66 ± 7.26 years were studied. Their mean TRUS estimated TPV, TRUS estimated TZV, TRUS estimated VES and EPW were 93.1mls, 53.3mls, 69.9mls and 79.1g respectively. Pearson’s correlation coefficient between the TRUS estimated TPV and EPW; TZV and EPW; & VES and EPW were 0.932, 0.865 and 0.930 respectively (p = 0.0000). Paired sample t-test however showed a statistically significant mean difference of -13.98 between the TRUS estimated TPV and EPW. The mean differences between the TRUS estimated TZV and EPW as well as between the VES and EPW were also statistically significant, being +25.79 and +9.19 respectively. The statistically significant differences in mean values persisted after the data was split into two groups, using TPV of 100mls as cut off. The regression formulae ‘prostate specimen weight = -32.584 + 1.20 × (pre-op TRUS TPV)’ and ‘prostate specimen weight = -22.651 + 1.91 × (pre-op TRUS TZV)’ were generated.


Conclusions : The significant differences between the TRUS estimated prostate volumes and the EPW, unrelated to the size of the prostate, suggests that TRUS may not be as accurate for prostate volume estimation as previously believed. Simple regression formulae could however be used to predict the expected weight of the prostate specimen after pre-operative TRUS.

Rotimi A. David

Senior Clinical Fellow
Department of Urology, Morriston hospital, ABM University Health Board, Swansea, United Kingdom
Swansea, Wales, United Kingdom

Dr Rotimi David
MBBS, FWACS
Urology Department, Morriston hospital, ABM University Health Board,
Swansea, UK

Tajudeen A. Badmus

Professor
Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria
Ile-Ife, Osun, Nigeria

Abdulkadir A. Salako

Professor
Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria
Ile-Ife, Osun, Nigeria

Christiana M. Asaleye

Consultant Radiologist
Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria
Ile-Ife, Osun, Nigeria

Davies O. Adeloye

Senior Research Fellow,
Nigerian Urban Reproductive Health Initiative, Abuja, Nigeria
Abuja, Federal Capital Territory, Nigeria

Olubukola O. Fanimi

Consultant Radiologist
Queen Mohamato Memorial Hospital, Lesotho
Maseru, Maseru, Lesotho