Suprapubic Ultrasonographic Findings of the Prostatic Diseases

Kim, Nam Doo; Kwon, Sung Won

Abstract

There have been much limitations and errors in evaluating prostatic conditions by traditional radiologic methods due to its location and anatomical structure. However recent introduction and improvement of the ultrasonography have been enabled us to visualize boundary of the prostate clearly and differentiate the variable findings within the prostate. Transrectal or transurethral ultrasonography of the prostate is popular nowadays, however we performed suprapubic ultrasonography of which merits are traumatic to the patients, easy to perform and it requires no adjustments or additions to basic ultrasound equipment. In order to evaluate ultrasonogram of the prostate in patients with prostatic diseases and normal adults and compare preoperative volume of the prostate on ultrasonographic estimation with postoperative volume, 31 patients with prostatic diseases and 40 normal adults under the age 60 were studied with suprapubic ultrasonography. The results obtained were as follows. 1. On ultrasonographic picture of the prostate, normal adults showed symmetrical or triangular or elliptical appearance and there were numerous fine homogenous spots within the prostate. BPH patients showed symmetric, round or oval shapes and its margin was smooth and numerous fine spots were seen within the prostate as normal adults. The prostatic size enlarged and elevated to the bladder base. Advanced prostatic cancer patients showed dyssymmetric irregular appearance. The prostate of acute prostatitis patients resembled normal prostate but prostatic size enlarged. 2. The mean prostatic volume of normal adults on ultrasonographic estimation was 21.30+/-24.80 cm3 and there were no differences of the prostatic volume between ages. 3. The mean prostatic volume of 21 BPH patients on ultrasonographic estimation was 46.2+/-17.2 cm3 and majority patients were in 33.49-61.56 cm3. 4. Comparisonal studies between preoperative ultrasonographic prostatic volume and resected prostatic volume showed correlation coefficient 0.98 (P<0.005) and mean error rate 17.58+/-8.1%. Most cases showed preoperative prostatic volume was larger than the postoperative volume which was probably due to inadequate removal of tissue and surgical capsule. As results of the above, the suprapubic ultrasonography was helpful in differential diagnosis of the prostatic diseases and estimation of the prostatic size.