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Abstract

Objectives: To study the impact of intravesical prostatic protrusion on urinary disorders in a population of patients aged over 40 years in the general radiology department of a level 3 hospital in sub-Saharan Africa. Material and Methods: This was a prospective, descriptive, cross-sectional study conducted over a 09-month period from March 2019 to November 2019. We included, all patients with intravesical prostatic protrusion related to BPH who gave their consent to participate in the study. We collected 40 records. The mean age was 66.43 years with extremes of 49 and 90 years. Statistical analysis of our results was performed with SPSS 20.0 software. Results: Ultrasound found prostatic volume between 25-50 ml in 18 patients (45%), ≥ 50-100 ml in 16 patients (40%) and ≥ 100 ml in 6 patients (15%). A grade 3 prostatic protrusion index was observed in 35 patients (87.5%). Five patients (12.5%) had a grade 2 protrusion prostatic index. No cases of grade 1 PPI were observed. In 14 patients, we found a struggle bladder with diffuse parietal thickening. No cases of renal involvement were observed. One poorly followed hypertensive patient had cortico-medullary dedifferentiation. Comparative analysis of means did not find an association between protrusion prostatic index and Prostate volume (P-value 0 .176).  A significant association was found between prostatic protrusion index and the international prostate symptom score (P-value = 0.006) and between protrusion prostatic index and Q max (P-value =0 .035). Conclusion: The prostatic protrusion index is a good marker of the severity of urinary symptoms. It should be evaluated during ultrasound examinations in elderly subjects presenting with a prostatic picture.


RESUME


Objectifs : Étudier l’impact de la protrusion prostatique intra vésicale sur les troubles urinaires dans une population de patients âgés de plus de 40 ans au service de radiologie générale d’un hôpital de niveau 3 en Afrique sub-saharienne.


Matériel et Méthodes : Il s’agissait d’une étude prospective, descriptive, transversale réalisée sur une période de 09 mois allant de mars 2019 à novembre 2019. Nous avons inclus, tous les patients ayant une protrusion prostatique intra vésicale liée à une hypertrophie bénigne de la prostate et ayant donné leur consentement pour participer à l’étude. Nous avons colligé 40 dossiers. L’âge moyen était de 66,43 ans avec des extrêmes de 49 et 90 ans. L’analyse statistique de nos résultats a été réalisée avec les logiciels SPSS 20.0.


Résultats :  L’échographie a trouvé un volume prostatique entre 25-50 ml chez 18 patients (45%), ≥ 50-100 ml chez 16 patients (40%) et ≥ 100 ml chez 6 patients (15%). Un indice de protrusion prostatique grade 3 était observé chez 35 patients (87,5%). Cinq patients (12,5%) avaient un IPP de grade 2. Aucun cas d’indice de protrusion prostatique de grade 1 n’a été observé. Chez 14 patients, nous avons trouvé une vessie de lutte avec un épaississement pariétal diffus. Aucun cas de retentissement rénal n’a été observé. Un patient hypertendu mal suivi présentait une dédifférenciation cortico-médullaire. L’analyse comparative des moyennes n’a pas noté d’association entre l’IPP et le VP (P- value 0 ,176).  Une association significative a été trouvée entre l’IPP et l’International Prostate Symptom Score (P-value = 0,006) et entre l’indice de protrusion prostatique et le Q max (P-value =0 ,035).


Conclusion : L’indice de protrusion prostatique est un bon marqueur de la sévérité des symptômes urinaires. Il doit être évalué lors des examens échographiques chez les sujets âgés présentant un tableau de prostatisme.

Article Details

How to Cite
Administrateur- JAIM, BADJI Nfally, LO Ndeye Astou, AKPO Geraud, NDIATH Abdoulaye, AIDARA Cherif Mouhamadou, DEME Hamidou, BA Sokhna, & NIANG El Hadji. (2022). Etude échographique de l’indice de protrusion prostatique. Journal Africain d’Imagerie Médicale (J Afr Imag Méd)., 13(4). https://doi.org/10.55715/jaim.v13i4.283

References

  1. 1. Costa P, Ben K N, Boukaram M, Wagner L, Louis J-F. Benign prostatic hyperplasia (BPH): prevalence in general practice and practical approach of French general practitioners. Results of a study based on 17,953 patients.
  2. Progrès en urologie : Journal de l'Association française d'urologie et de la Société française d'urologie. 2004;14(1):33-3.
  3. 2. Kok ET, Schouten BW, Bohnen AM, Groeneveld FP, Thomas Siep, Ruud Bosch. Risk factors for lower urinary tract symptoms suggestive of benign prostatic hyperplasia in a community-based population of healthy aging men: the Krimpen Study. The Journal of urology. 2009;181(2):710-6.
  4. 3. Oelke M, Höfner K, Jonas U, De la Rosette J J, Ubbink D T, Wijkstra. Diagnostic accuracy of noninvasive tests to evaluate bladder outlet obstruction in men: detrusor wall thickness, uroflowmetry, postvoid residual urine, and prostate volume. European urology. 2007;52(3):827-35.
  5. 4. Ohnuki T, Kurokawa K, Katoh N, Fukabori Y, Shimizu K, Nakai K, Yamanaka H. Transrectal longitudinal ultrasonography of the prostate by electronic linear scanning (1). Hinyokika kiyo. Acta urologica Japonica. 1987;33(9):1385-8
  6. 5. Keqin Z, Zhishun X, Jing Z, Haixin W, Dongqing Z, Benkang S. Clinical significance of intravesical prostatic protrusion in patients with benign prostatic enlargement. Urology. 2007;70(6):1096-9.
  7. 6. Robert G, Descazeaud A, Delongchamps NB, Cornu J-N, Azzouzi A R, Haillot O et al. Benign prostatic hyperplasia medical treatment: systematic review of the literature by the CTMH/AFU. Progrès en urologie : journal de l'Association française d'urologie et de la Société française d'urologie. 2012;22(1):7-12
  8. 7. Descazeaud A, Robert G, Delongchamps NB, Cornu JN, Saussine C, Haillot O et al. Bilan initial et suivi de l’hyperplasie bénigne de prostate : revue de littérature du CTMH de l’AFU. Progrès en urologie. 2012; 22(1): 1-6.
  9. 8. Lebdai S, Ammi M, Bigot P, Cornu J-C, R Mathieu, Descazeaud A et al. Impact en pratique clinique de l’indice de protrusion prostatique intra-vésicale : une revue de la littérature du CTMH de l’AFU. Progrès en urologie. 2014 ; 24(5) : 313-8
  10. 9. Crawford ED, Wilson SS, McConnell JD, Slawin K M, Lieber M C, Smith J A et al. Baseline factors as predictors of clinical progression of benign prostatic hyperplasia in men treated with placebo. The Journal of urology. 2006;175(4):1422-7.
  11. 10. Delongchamps NB, Robert G, Descazeaud A Cornu J-N, Azzouzi A R, Haillot O et al. Surgical management of benign prostatic hyperplasia by endoscopic techniques using electricity and open prostatectomy: a review of the literature by the LUTS committee of the French Urological Association. Progrès en urologie : journal de l'Association française d'urologie et de la Société française d'urologie. 2012;22(2):73-9
  12. 11. Descazeaud A, Robert G, Delongchamps NB, Cornu JN, Saussine C, Haillot O et al. Initial assessment, follow-up and treatment of lower urinary tract symptoms related to benign prostatic hyperplasia: guidelines of the LUTS committee of the French Urological Association. Progrès en urologie : journal de l'Association française d'urologie et de la Société française d'urologie. 2012;22(16):977-88.
  13. 12. Roehrborn CG, McConnell JD, Lieber M, Kaplan S, Geller J, Malek G H et al. Serum prostate-specific antigen concentration is a powerful predictor of acute urinary retention and need for surgery in men with clinical benign prostatic hyperplasia. Urology. 1999;53(3):473-80.
  14. 13. Franco G, De Nunzio C, Leonardo C, Tubaro A, Ciccariello M, De Dominicis C et al. Ultrasound assessment of intravesical prostatic protrusion and detrusor wall thickness-new standards for noninvasive bladder outlet obstruction diagnosis? The Journal of urology. 2010;183(6):2270-4.
  15. 14. Chia SJ, Heng CT, Chan SP, Foo K T. Correlation of intravesical prostatic protrusion with bladder outlet obstruction. BJU international. 2003;91(4):371-4
  16. 15. Lee JM, Chung H, Kim TW. La corrélation de la protrusion prostatique intra vésicale avec les symptômes de stockage, telle que mesurée par échographie transrectale. Korean J Urol. 2008; 49: 145-9.
  17. 16. Bhomi K K, Bhattachan C L. Factors predicting the success of a trial without catheter in acute urinary retention secondary to benign prostatic hyperplasia. Nepal Medical College journal. 2011;13(3):178-81
  18. 17. Mariappan P, Brown DJ, McNeill AS. Intravesical prostatic protrusion is better than prostate volume in predicting the outcome of trial without catheter in white men presenting with acute urinary retention: a prospective clinical study. The Journal of urology. 2007;178(2):573-7.
  19. 18. Sharis O S , Zulkifli M Z, Hamzaini A H. Predicting outcome of trial of voiding without catheter in acute urinary retention with intravesical prostatic protrusion. The Malaysian journal of medical sciences. (2013);20(1):56.
  20. 19. 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. International neurourology journal. 2012;16(4):187
  21. 20. Lee JW, Ryu JH, Yoo TK, Byun S S, Jeong Y J, Jung T Y et al. Relationship between intravesical prostatic protrusion and postoperative outcomes in patients with benign prostatic hyperplasia. Korean journal of urology. 2012;53(7):478-82.
  22. 21. McConnel JD, Roehrborn CG, Bautista OM, Andriole G L, Dixon C, Kusek J Wet al. The long-term effect of doxazosin, finasteride, and combination therapy on the clinical progression of benign prostatic hyperplasia. New England Journal of Medicine. 2003;349(25):2387-98.
  23. 22. Reynard JM, Shearer RJ. Failure to void after transurethral resection of the prostate and mode of presentation. Urology. 1999;53(2):336-9.
  24. 23. GreenW, Campain N, Peracha A, Ratan H, Walton T, Parkinson R et al. Very high residual volumes should not prevent transurethral resection of the prostate being offered to men presenting with urinary retention. Scandinavian journal of urology. 2014;48(6):549-53.
  25. 24. Grossfeld GD, Coakley FV. Benign prostatic hyperplasia: clinical overview and value of diagnostic imaging. Radiologic Clinics of North America. 2000;38(1):31-47
  26. 25. Rule AD, Jacobson DJ, Roberts R O, Girman C J, McGree M E, Lieber M M et al. The association between benign prostatic hyperplasia and chronic kidney disease in community-dwelling men. Kidney international. 2005;67(6):2376-82.
  27. 26. Park SC, Lee JW, Rim JS. The relationship between intravesical prostatic protrusion and pressure flow study findings in patients with benign prostate obstruction/lower urinary tract symptoms. Actas Urológicas Españolas (English Edition). 2012;36(3):165-70.
  28. 27. Wang D, Huang H, Law YM, Foo KT. Relationships between prostatic volume and intravesical prostatic protrusion on transabdominal ultrasound and benign prostatic obstruction in patients with lower urinary tract symptoms. Ann Acad Med Singapore. 2015;44(2):60-5.
  29. 28. Han WK, Shan GZ, Jin J. Correlation of intravesical prostatic protrusion with clinical evaluation parameters in BPH patients. Zhonghua nan ke xue= National Journal of Andrology. 2010;16(3):254-7.
  30. 29. Lieber MM, Jacobson DJ, McGree ME, St Sauver J L, Girman J C, Jacobsen J S et al. Intravesical prostatic protrusion in men in Olmsted County, Minnesota. The Journal of urology. 2009;182(6):2819-24.
  31. 30. Eze BU, Mbaeri TU, Oranusi KC, Abiahu J A, Nwofor A M, Orakwe J C et al. Correlation between intravesical prostatic protrusion and international prostate symptom score among Nigerian men with benign prostatic hyperplasia. Nigerian journal of clinical practice. 2019;22(4):454.
  32. 31. Lee A, Lee HJ, Lim KB. La protrusion prostatique intra vésicale peut-elle prédire l'obstruction de la sortie de la vessie, même chez les hommes avec un bon écoulement ? Asian J Urol.2016; 3: 39-43.
  33. 32. Lu SY, Yang CM, Fan YH. La protrusion intra vésicale de la prostate est bien corrélée avec les symptômes de stockage chez les patients âgés de sexe masculin présentant une vessie hyperactive non neurogène. Urol Sci. 2016; 27: 17-20.
  34. 33. Tjahjodjati T, Santoso J. Relation de l'angle prostate-urétral et de la protrusion prostatique intravésicale avec le score international des symptômes prostatiques et l'uroflowmetry chez les patients atteints d'hyperplasie bénigne de la prostate. Int J Integr Health Sci. 2015; 3: 50-4.
  35. 34. Sigdel G, Belokar WK. Signification clinique de la protrusion prostatique intravésicale chez les patients atteints d'hyperplasie bénigne de la prostate. J Univ Coll Med Sci. 2015; 3: 6-10

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