Reference
Reference
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Study Type
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Patients/Events
Study Objective(Purpose of Study)
Study Objective(Purpose of Study)
Study Results
Study Results
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Study Quality
1. O'Brien WM. Benign prostatic hypertrophy. Am Fam Physician. 1991;44(1):162-171. Review/Other-Dx N/A To review physiology, presentation and treatment of benign prostatic hypertrophy. The mainstay of treatment is transurethral resection of the prostate. It provides relief in 85% of patients. 4
2. Takeda M, Araki I, Kamiyama M, Takihana Y, Komuro M, Furuya Y. Diagnosis and treatment of voiding symptoms. Urology. 2003;62(5 Suppl 2):11-19. Review/Other-Dx N/A To review signs, symptoms and diagnosis of urinary tract obstructive symptoms. Pressure flow study is an important test for differential diagnosis between obstruction and nonobstructive patients, but alternative noninvasive tests are necessary due to its shortcomings. 4
3. Berry SJ, Coffey DS, Walsh PC, Ewing LL. The development of human benign prostatic hyperplasia with age. J Urol. 1984;132(3):474-479. Review/Other-Dx 10 studies To report the prevalence and growth rate of human BPH with age by combining and analyzing data from 10 independent studies containing more than 1,000 prostates. An analysis of a logistic growth curve of BPH lesions removed at prostatectomy indicates that the growth of BPH is initiated probably before the patient is 30 years old. The early phase of BPH growth (men between 31 and 50 years old) is characterized by a doubling time for the tumor weight of 4.5 years. In the mid phase of BPH growth (men between 51 and 70 years old) the doubling time is 10 years, and increases to more than 100 years in patients beyond 70 years old. 4
4. Sarma AV, Wei JT. Clinical practice. Benign prostatic hyperplasia and lower urinary tract symptoms. N Engl J Med. 2012;367(3):248-257. Review/Other-Dx N/A No abstract available. No abstract available. 4
5. Grossfeld GD, Coakley FV. Benign prostatic hyperplasia: clinical overview and value of diagnostic imaging. [Review] [70 refs]. Radiol Clin North Am. 38(1):31-47, 2000 Jan. Review/Other-Dx N/A Clinical overview and diagnostic imaging of BPH. Routine upper tract imaging not indicated in patients with lower urinary tract symptoms. Local imaging of prostate can be performed with TRUS or MRI. 4
6. Talner LB. Specific causes of obstruction. In: Pollack HM, ed. Clinical urography. Philadelphia, Pa: WB Saunders; 1990:chapter 56. Review/Other-Dx N/A Book chapter. N/A 4
7. Stacul F, Rossi A, Cova MA. CT urography: the end of IVU? Radiol Med. 2008;113(5):658-669. Review/Other-Dx N/A Review literature comparing diagnostic accuracy of MDCTU and IVU. MDCTU has a high diagnostic accuracy. 4
8. Ozden E, Gogus C, Kilic O, Yaman O, Ozdiler E. Analysis of suprapubic and transrectal measurements in assessment of prostate dimensions and volume: is transrectal ultrasonography really necessary for prostate measurements?. Urol. j.. 6(3):208-13, 2009Summer. Observational-Dx 100 consecutive patients with lower urinary tract symptoms To evaluate the correlation of suprapubic US and TRUS in measurements of prostate dimension and volume. Measurements of the 3 dimensions of the prostate (anteroposterior, transverse, and craniocaudal) and its volume performed by suprapubic US were compared with the corresponding measurements by TRUS. Mean prostate volume of patients, measured by suprapubic and TRUS 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 TRUS measurements also showed significant correlations for both prostates smaller or larger than 50 mL. There was strong correlation between suprapubic and TRUS measurements of the prostate sizes, including both for volume or specific dimension measurements. 3
9. Abrams P, Chapple C, Khoury S, Roehrborn C, de la Rosette J. Evaluation and treatment of lower urinary tract symptoms in older men. J Urol. 2013;189(1 Suppl):S93-S101. Review/Other-Dx N/A The 6th International Consultation on New Developments in Prostate Cancer and Prostate Diseases met from June 24-28, 2005 in Paris, France to review new developments in benign prostatic disease. The Consultation endorsed the appropriate use of the current terminology lower urinary tract symptoms/BPH/benign prostate enlargement and benign prostatic obstruction, and recommended that terms such as "clinical benign prostatic hyperplasia" or "the benign prostatic hyperplasia patient" be abandoned, and asked the authorities to endorse the new nomenclature. The diagnostic evaluation describes recommended and optional tests, and in general places the focus on the impact (bother) of lower urinary tract symptoms on the individual patient when determining investigation and treatment. The importance of symptom assessment, impact on quality of life, physical examination and urinalysis is emphasized. The frequency volume chart is recommended when nocturia is a bothersome symptom to exclude nocturnal polyuria. The recommendations are summarized in 2 algorithms, 1 for basic management and 1 for specialized management of persistent bothersome lower urinary tract symptoms. 4
10. McAchran SE, Hartke DM, Nakamoto DA, Resnick MI. Sonography of the Urinary Bladder. Ultrasound Clinics. 2007;2(1):17-26. Review/Other-Dx N/A To review usefulness of bladder US. Bladder US is useful in determination of the presence and volume of postvoid residual urine, assessment of suspected bladder stones, diverticula, and other lesions, evaluation of the bladder neck for hypermobility , and assessment of pediatric patients who have posterior urethral valves, ureteroceles, and, more recently, vesicoureteral reflux. 4
11. Cascione CJ, Bartone FF, Hussain MB. Transabdominal ultrasound versus excretory urography in preoperative evaluation of patients with prostatism. J Urol. 1987;137(5):883-885. Observational-Dx 53 patients To compare US and excretory urography in preoperative evaluation of patients with prostatism. US proved to be more accurate in defining prostatic size and configuration. Bladder wall thickness also was quantified more clearly with US. The authors found 17 renal masses incidentally with excretory urography, although US was essential and superior to excretory urography in defining these masses in each case. Authors recommend that US be used in lieu of excretory urography when imaging of the urinary tract is indicated before prostatectomy. 3
12. Roehrborn CG, Chinn HK, Fulgham PF, Simpkins KL, Peters PC. The role of transabdominal ultrasound in the preoperative evaluation of patients with benign prostatic hypertrophy. J Urol. 1986;135(6):1190-1193. Observational-Dx 59 patients To determine role of transabdominal US in the preoperative evaluation of patients with benign prostatic hypertrophy. Compared excretory urography, post voiding volumes, uroflowmetry, and transabdominal US. Best predictor of prostate weight is US (r = 0.975) and with digital rectal examination and urethrocystoscopy there was a tendency to overestimate small and underestimate large glands. Symptoms such as nocturia do not allow any conclusions about the size of the prostate. The correlation between post-void residual and specimen weight also is poor and only patients in retention (Foley catheter) have a significantly larger prostate. Preoperative uroflowmetry provides limited information about the prostatic size but, although the difference between the preoperative and postoperative flow rate index is highly significant (P<0.001, mean difference test), the correlation between specimen weight, and the difference between preoperative and postoperative flow rate index is not significant. 2
13. Liney GP, Turnbull LW, Knowles AJ. In vivo magnetic resonance spectroscopy and dynamic contrast enhanced imaging of the prostate gland. NMR Biomed. 1999;12(1):39-44. Review/Other-Dx N/A To describe in vivo 1H MRS and dynamic contrast enhanced imaging of the prostate gland. The combined use of in vivo 1H MRS and dynamic contrast enhanced MRI studies may improve the staging accuracy of MRI. 4
14. Berger AP, Horninger W, Bektic J, et al. Vascular resistance in the prostate evaluated by colour Doppler ultrasonography: is benign prostatic hyperplasia a vascular disease?. BJU Int. 98(3):587-90, 2006 Sep. Observational-Dx 92 men To evaluate prostatic vascular resistance by measuring the RI, and flow velocity using color Doppler US, in normal prostates and in patients with BPH or prostate cancer, as BPH is considered to be a result of urogenital ageing and studies suggest that hyperplasia in the stromal and glandular compartments might be induced by stromal growth secondary to hypoxia, which in turn results from abnormal blood flow patterns. The mean RI in the transition zone was significantly higher only in patients with BPH, at 0.77 (0.05), versus 0.65 (0.05) in the other 2 groups. In the peripheral and central zones there was no significant difference in the RI among the 3 groups. Arterial color Doppler US flow velocity was increased in the transition zone of patients with BPH, but not in the peripheral and central zones. 3
15. Tsuru N, Kurita Y, Suzuki K, Fujita K. Resistance index in benign prostatic hyperplasia using power Doppler imaging and clinical outcomes after transurethral vaporization of the prostate. Int J Urol. 2005;12(3):264-269. Review/Other-Dx 43 patients To examine change of RI before and after transurethral vaporization of the prostate in BPH patients using power Doppler imaging and clinical outcomes. RI significantly decreased post therapy as did other urodynamic parameters. RI could be used to evaluate severity of BPH. 4
16. Amiel GE, Slawin KM. Newer modalities of ultrasound imaging and treatment of the prostate. Urol Clin North Am. 2006;33(3):329-337. Review/Other-Dx N/A To review developments in US of the prostate. Evaluation of benign prostatic hypertrophy does not require routine imaging of prostate. TRUS useful for size and texture. Transabdominal US useful for upper tracts and bladder volume. 4
17. Halpern EJ, Ramey JR, Strup SE, Frauscher F, McCue P, Gomella LG. Detection of prostate carcinoma with contrast-enhanced sonography using intermittent harmonic imaging. Cancer. 2005;104(11):2373-2383. Observational-Dx 301 patients To assess prostate carcinoma detection and discrimination of benign from malignant prostate tissue with contrast-enhanced US. Carcinoma was detected in 363 biopsy cores from 104/301 subjects (35%). Carcinoma was found in 15.5% (175/1133) of targeted cores and 10.4% (188/1806) of sextant cores (P<0.01). Among subjects with carcinoma, targeted cores were twice as likely to be positive (odds ratio = 2.0, P<0.001). Clustered ROC analysis of imaging findings at sextant biopsy sites yielded the following Az values: precontrast gray scale: 0.58; precontrast color Doppler: 0.53; precontrast power Doppler: 0.58; continuous harmonic imaging: 0.62; intermittent harmonic imaging (0.2 sec): 0.64; intermittent harmonic imaging (0.5 sec): 0.63; intermittent harmonic imaging (1.0 sec): 0.65; intermittent harmonic imaging (2.0 sec): 0.61; contrast-enhanced color Doppler: 0.60; contrast-enhanced power Doppler: 0.62. A statistically significant benefit was found for intermittent harmonic imaging over baseline imaging (P<0.05). 2
18. Hamper UM, Trapanotto V, DeJong MR, Sheth S, Caskey CI. Three-dimensional US of the prostate: early experience. Radiology. 1999;212(3):719-723. Observational-Dx 16 patients To assess feasibility of 3-D endorectal transducer US in the prostate gland. Patients had 3-D following conventional 2-D US. 3-D US allowed better visualization of the gland and focal lesions. Prostatic volumes obtained from 3-D US were consistently smaller than volumes obtained from 2-D US (20% difference, P=.006). 3-D was superior to 2-D US in depicting tumor presence (9/10 right hemispheres, 3 out of 8 left hemispheres) and extraglandular extent of disease (3/5 hemispheres). 3
19. Oelke M, Hofner K, Jonas U, de la Rosette JJ, Ubbink DT, Wijkstra H. Diagnostic accuracy of noninvasive tests to evaluate bladder outlet obstruction in men: detrusor wall thickness, uroflowmetry, postvoid residual urine, and prostate volume. Eur Urol. 52(3):827-34, 2007 Sep. Observational-Dx 160 patients Prospective study to compare the diagnostic accuracy of detrusor wall thickness, free uroflowmetry, postvoid residual urine, and prostate volume (index tests) with pressure-flow studies (reference standard) to detect bladder outlet obstruction in men. Detrusor wall thickness was the most accurate test: Positive predictive value was 94%, specificity 95%, and the area under the curve of ROC analysis 0.93. There was an agreement of 89% between the results of detrusor wall thickness measurement and pressure-flow studies. 2
20. Franco G, De Nunzio C, Leonardo C, et al. Ultrasound assessment of intravesical prostatic protrusion and detrusor wall thickness--new standards for noninvasive bladder outlet obstruction diagnosis?. J Urol. 183(6):2270-4, 2010 Jun. Observational-Dx 100 consecutive patients with lower urinary tract symptoms Prospective study to evaluate the accuracy of detrusor wall thickness and IPP, and the association of each test to diagnose bladder prostatic obstruction in patients with lower urinary tract symptoms. The association of IPP and detrusor wall thickness produced the best diagnostic accuracy (87%) when the 2 tests were done consecutively. Suprapubic US of detrusor wall thickness and IPP is a simple, noninvasive, accurate system to assess bladder prostatic obstruction in patients with lower urinary tract symptoms due to BPH. 2
21. Cumpanas AA, Botoca M, Minciu R, Bucuras V. Intravesical prostatic protrusion can be a predicting factor for the treatment outcome in patients with lower urinary tract symptoms due to benign prostatic obstruction treated with tamsulosin. Urology. 81(4):859-63, 2013 Apr. Observational-Tx 183 patients To assess the effect of the IPP on the response to medical treatment with tamsulosin for a 3 month period. After 3 months of treatment, Qmax increased, with 2.74 mL/s (25%) in group A (P<.01) and 1.59 mL/s (19%) in group B (P=.07). IPSS decreased, with 39.9% (P<.01) and 29.7% (P=.08), respectively. Statistically significant differences were noted for IPSS -35% responders (78% group A vs 58% group B, P<01), -3 points IPSS responders (82% vs 64%), Qmax +25% responders (82% vs 58%), and Qmax +1.6 mL/s responders (85% vs 62%, P<.01). No major adverse events occurred. The relative small number of patients enrolled was the main study limitation. 2
22. Seo YM, Kim HJ. Impact of intravesical protrusion of the prostate in the treatment of lower urinary tract symptoms/benign prostatic hyperplasia of moderate size by alpha receptor antagonist. Int Neurourol J. 2012;16(4):187-190. Observational-Tx 77 BPH patients To evaluate whether IPP is related to the treatment effect of alpha-1 receptor antagonist in patients with lower urinary tract symptoms/BPH with a prostate size of less than 40 grams. Prostate-specific antigen and IPSS (total and voiding subscore) showed significant correlations with IPP (P<0.05). Comparison of parameters before and after 8 weeks showed that alfuzosin improved the total IPSS and all subscores (P<0.001), quality of life (P<0.001), Qmax (P<0.001), and PVR (P=0.030) in the non-IPP group. 1
23. Beacock CJ, Roberts EE, Rees RW, Buck AC. Ultrasound assessment of residual urine. A quantitative method. Br J Urol. 1985;57(4):410-413. Review/Other-Dx 15 patients To describe a method of measuring residual urine with US. The volume is computed from serial parallel sections of the bladder. This method is found to be significantly more accurate than previously reported techniques and is quick and easy to perform. 4
24. Rosenkrantz AB, Deng FM, Kim S, et al. Prostate cancer: multiparametric MRI for index lesion localization--a multiple-reader study. AJR Am J Roentgenol. 2012;199(4):830-837. Observational-Dx 51 patients To evaluate the utility of multiparametric MRI in localization of the index lesion of prostate cancer. The pathologist identified an index lesion in 49/51 patients. In exact-match analysis, the average sensitivity was 60.2% (range, 51.0%–63.3%), and the average positive predictive value was 65.3% (range, 61.2%–69.4%). In approximate-match analysis, the average sensitivity was 75.9% (range, 65.3%–69.6%), and the average positive predictive value was 82.6% (range, 79.2%–91.4%). The sensitivity was higher for index lesions with a Gleason score >6 in exact-match (74.8% vs 15.3%, P<0.001) and approximate-match (88.7% vs 36.1%, P=0.001) analyses and for index lesions measuring at least 1 cm in approximate-match analysis (80.3% vs 58.3%, P=0.016). In exact-match analysis, 30.0%, 44.9%, and 79.1% of abnormalities found with one, two, and three MRI parameters represented the index lesion (P<0.001). 2
25. Turkbey B, Pinto PA, Mani H, et al. Prostate cancer: value of multiparametric MR imaging at 3 T for detection--histopathologic correlation. Radiology. 2010;255(1):89-99. Observational-Dx 70 patients To determine utility of multiparametric imaging performed at 3 T for detection of prostate cancer by using T2-weighted MRI, MRS, and dynamic contrast material-enhanced MRI, with whole-mount pathologic findings as reference standard. For T2-weighted MRI, sensitivity and specificity values obtained with stringent approach were 0.42 (95% confidence interval: 0.36, 0.47) and 0.83 (95% confidence interval: 0.81, 0.86), and for the alternative neighboring approach, sensitivity and specificity values were 0.73 (95% confidence interval: 0.67, 0.78) and 0.89 (95% confidence interval: 0.85, 0.93), respectively. The combined diagnostic accuracy of T2-weighted MRI, dynamic contrast-enhanced MRI, and MRS for peripheral zone tumors was examined by calculating their predictive value with different combinations of techniques; T2-weighted MRI, dynamic contrast-enhanced MRI, and MRS provided significant independent and additive predictive value when GEEs were used (P<.001, P=.02, P=.002, respectively). 1
26. Brooks AP. Prostatism, intravenous urography and asymptomatic renal cancer. Br J Urol. 1988;62(1):1-3. Review/Other-Dx N/A To determine value of performing IVU in asymptomatic patient. Difficult to justify routine IVU exams in patients with prostatism. A radiograph of value to detect calculi. US of upper and/or lower urinary tract can be alternative to IVU. 4
27. Wasserman NF, Lapointe S, Eckmann DR, Rosel PR. Assessment of prostatism: role of intravenous urography. Radiology. 1987;165(3):831-835. Observational-Dx 502 patients Prospective study of patients referred for assessment of symptoms of bladder outlet obstruction was performed to determine the value of routine IVU. Abnormalities were found in 23% of patients but significant conditions in only 10%. Occult significant abnormalities that would have been missed without IVU occurred in only 1.5% of patients. Most of these could be detected on an abdominal radiograph. Only one malignancy would have been missed without routine IVU. The authors conclude that IVU in the assessment of prostatism should be limited to patients with positive findings in the clinical workup. An abdominal radiograph is recommended in the others. Significant cost savings can thus be achieved. 3