Analysis of Suprapubic and Transrectal Measurements in Assessment of Prostate Dimensions and Volume: Is Transrectal Ultrasonography Really Necessary for Prostate Measurements?

<p><strong>Introduction:</strong> The objective of this study was to evaluate the correlation of suprapubic ultrasonography and transrectal ultrasonography in measurements of prostate dimension and volume.</p><p><strong>Materials and Methods: </strong>One hundred consecutive patients with lower urinary tract symptoms were examined by suprapubic and transrectal ultrasonography modalities in a same session. Measurements of the 3 dimensions of the prostate (anteroposterior, transverse, and craniocaudal) and its volume performed by suprapubic ultrasonography were compared with the corresponding measurements by transrectal ultrasonography in order to determine the correlation of the measurements. Prostate volumes were calculated using the ellipsoid formula. Data were further analyzed in subgroups according to prostate volumes smaller or larger than 50 mL, measured by suprapubic ultrasonography.</p><p><strong>Results:</strong> The mean prostate volume of the 100 patients, measured by suprapubic and transrectal ultrasonography were 65.9 ± 35.8 mL and 62.5 ± 32.0 mL, respectively (r = 0.94; P < .001). The craniocaudal diameters had the strongest correlation among dimension measurements (r = 0.89; P < .001). Suprapubic and transrectal ultrasonography measurements also showed significant correlations for both prostates smaller or larger than 50 mL. Eighty-five percent of the patients had both volume measurements under or above this limit.</p><p><strong>Conclusion:</strong> There was strong correlation between suprapubic and transrectal ultrasonography measurements of the prostate sizes, including both for volume or specific dimension measurements.</p&gt

Comparison of imaging modalities for detection of residual fragments and prediction of stone related events following percutaneous nephrolitotomy

Introduction Achieving stone free status (SFS) is the goal of stone surgery. In this study it is aimed to compare effectiveness of unenhanced helical computerized tomography (UHCT), KUB and ultrasonography (US) for detection of residual RFs and predicition of stone releated events following percutaneous nephrolitotomy (PNL). Materials and Methods Patients underwent PNL for radiopaque stones between November 2007 and February 2010 were followed. Patients were examined within 24-48 hours after the procedure by KUB, US and UHCT. For stone size 4 mm was accepted as cut off level of significance.Sensitivity and specificity of KUB and US for detection of RFs and value of them for prediction of stone related events were calculated. Results SFS was achieved in 95 patients (54.9%) and when cut off value of 4 mm for RFs was employed, SFS was achieved in 131 patients (75.7%). Sensitivity was 70.5% for KUB, and 52.5% for US. UHCT was shown to be significantly more efficient for detection of RFs compared to both KUB (p=0.01) and US (p=0.001). When cut off level of 4 mm employed, sensitivity of KUB and US increased to 85.7% and 57.1%. Statistical significant superiority of UHCT still remained (p value vs. KUB: 0.03 and p value vs. US: 0.008). Conclusion UHCT is the most sensitive diagnostic tool for detecting RFs after PNL. It has higher sensitivity regardless of stone size compared to KUB and US. Additionally UHCT has higher capability of predicting occurrence of stone related events

Risk factors for infection development after transrectal prostate biopsy and the role of resistant bacteria in colonic flora.

Introduction: In this study, we aimed to identify risk factors for the development of infectious complications after prostate biopsy and to investigate the role of intestinal colonization of bacteria that are resistant to prophylactic antibiotics. Methodology: A total of 168 patients who had undergone transrectal prostate biopsy (TRPB) under ciprofloxacin and gentamycin prophylaxis were included in the study. Stool cultures and subsequent antibiotic susceptibility testing were performed in all patients before the start of antibiotic prophylaxis. Results: Of the 168 patients, 17 (10.1%) developed urinary tract infection (UTI), while 6 (3.57%) developed sepsis within seven days after biopsy. Ciprofloxacin-resistant bacterial colonization was detected in 81 (48.2%) of the patients. None of the patients with ciprofloxacin-sensitive bacteria in intestinal flora developed a UTI. The colonization of intestinal ciprofloxacin-resistant bacteria increased UTI risk significantly after TRPB (p < 0.0001). Urolithiasis history, presence of permanent urinary catheterization, hospitalization history for more than 48 hours in the last year, and recent antibiotic usage significantly increased UTI risk after TRPB. Conclusions: Development of an infection was more frequent in patients with resistant bacterial colonization. We hope to guide more comprehensive studies designed to find a standard prophylactic regimen for TRPB that can be used all over the world