經直腸攝護腺超音波在診斷年輕男性攝護腺炎的角色
許哲維1、黃建勳1,2、廖贊傑3、程威銘1,2、張彰琦1,2、邱逸淳1,2、洪士奇1、邱文祥1,2
1台北市立聯合醫院忠孝院區外科部泌尿科； 2國立陽明大學醫學院泌尿學科；3台北市立聯合醫院忠孝院區影像醫學科
The role of TRUS in diagnosing prostatitis for young men
Che-Wei Hsu1, Ken-J Chien-Hsun Huang 1,2, Tsan-Chieh, Liao3, Wei-Ming Cheng 1,2, Chang-Chi Chang 1,2, Yi-Chun Chiu1,2, Shih-Chi Hong1, Allen Chiu1,2
1Division of Urology, Department of Surgery, Taipei City Hospital, Zhongxiao Branch, Taipei, Taiwan
2Department of Urology, School of Medicine, National Yang-Ming University, Taipei, Taiwan
3Department of Medical Imaging, Taipei City Hospital, Zhongxiao Branch, Taipei, Taiwan
Purpose:
There were limited studies had been considered that TRUS in prostatitis as a supportive tool. We have noticed that there seemed to present some findings in TRUS with patients being suffered from prostatitis different from normal men, especially in young age. Thus, we tried to determine the role of TRUS in diagnosing prostatitis for the young men
Materials and Methods:
From Jan. 2015 to Feb. 2017, all patients younger than 40 years old who underwent TRUS at outpatient department in Taipei City Hospital Zhongxiao Brench were included. Patients with chronic prostatitis history or under antibiotics use for over one week before TRUS examination were excluded. Diagnosis of prostatitis was defined by medical records of history, digital rectal examination (DRE) and antibiotics use. Paravesical hypoechoic findings in TRUS were reviewed by one doctor who did not know the diagnosis of patients before. Size of prostate was measured by TRUS. Data of urine analysis and semen analysis were also collected. Fisher exact test, Mann-Whitney U test and multiple regression analysis were used for statistical analysis.
Results:
There were 46 patients younger than 40 years old who were undergoing TRUS from Jan. 2015 to Feb. 2017. Among these patients all were included to our analysis, 29 (63%) had diagnosis of prostatitis. Compared to patients without prostatitis, patient with prostatitis tended to be younger (31.3 versus 34.9, p=0.025). Also, they seemed to have smaller prostate (<20cm), but there was no statistical differences (p=0.092). The hypoechoic findings in TRUS were more probable to be noted in patients with prostatitis (75.9% versus 29.4%, p=0.009). Most of patients were diagnosed with mushy consistency with tenderness of the prostate which were noted during DRE. (93.1%). Hypoechoic findings remained significant after multivariate analysis (p = 0.015).
Conclusion:
From this community-based hospital study, we had found the association of paravesical hypoechoic lesions in TRUS and prostatitis. Therefore, we recommended the TRUS as a helpful tool in diagnosing prostatitis in young men.