Digital rectal grading of benign prostatic hyperplasia: Where does it stand today?

Lodh, Bijit; Sinam, Rajendra Singh; Singh, Kaku Akoijam

doi:10.4103/0971-9903.178104

Cited by 5 publications

(8 citation statements)

References 4 publications

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“…Romero et al, [3] documented a volume of 20 g for Grade I, 30 g for Grade I/II, 40 g for Grade II, 50 g for Grade II/III, 60 g for Grade III and 80 g or greater for Grade IV in their study. In their study Lodh, et al concluded that estimation of prostate size may be overestimated or underestimated by DRE but it gives a rough idea of prostate volume estimation [2].…”

Section: Original Research Articlementioning

confidence: 96%

“…International Journal of Medical Research and Review Available online at: www.medresearch.in 67 | P a g e current study used DRE grading mentioned by Lodh et al which is a modification of DRE grading described by Romero et al due to its simplistic nature [2,3]. The size of prostate lobes on DRE is not a criterion as to the size of their protrusion into the bladder.…”

Section: Original Research Articlementioning

confidence: 99%

“…An effective DRE requires a meticulous, thorough, and skilful examination technique that is usually acquired only after a fairly long learning curve. There have been various attempts to standardize the DRE grading in the past of which the work of Romero et al and recently Lodh et al has been most widely accepted [2,3]. Estimation of prostate size is important to guide the most appropriate pharmacological or surgical approach.…”

Section: Introductionmentioning

confidence: 99%

“…DRE was performed in a modified lithotomy position in which a patient rests on his back with hips and knees flexed and abducted. The current study used the DRE grading described by Lodh et al (Table 1) involving comment on the accessibility of upper limit, depth of lateral sulcus and condition of the median sulcus or posterior surface [2].…”

Section: Introductionmentioning

confidence: 99%

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Estimation of prostate size by trans-rectal ultrasound and its correlation with DRE and endoscopic grading

2020

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Aim: Digital rectal examination (DRE) grading and the grade of prostatomegaly on cystoscopy are routinely used in clinical practice, but its correlation to prostate volume is understudied. This study was done to assess the correlation of DRE and endoscopic grading with the prostate volume on trans-rectal ultrasound (TRUS). Materials and Methods: This study was carried out in 101 eligible patients with prostatomegaly. Each patient was evaluated for three parameters, prostate volume by TRUS examination, DRE and endoscopic grading on cystoscopy. Pearson correlation coefficient was calculated to find the correlation between variables, p<0.05 was taken to be statistically significant. Data were analyzed using the Epi Info (TM) 7.2.2.2. Results: Significant positive correlation (p<0.001) was found between TRUS Volume and DRE grading (Pearson Correlation=0.945) and TRUS volume and Endoscopic grading (Pearson Correlation=0.949). Both the grading were also significantly positively correlated (Pearson Correlation=0.989, p<0.001). Conclusion: Our attempt for correlating the digital rectal grading and endoscopic grading with prostate volume is satisfactorily validated in the clinical setting. These grades are sufficient to provide a rough estimation of the prostate volume and to classify patients with prostatomegaly.

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Section: Original Research Articlementioning

confidence: 96%

Section: Original Research Articlementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Estimation of prostate size by trans-rectal ultrasound and its correlation with DRE and endoscopic grading

2020

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“…The inclusion criteria were refractory retention of urine, moderate to severe score in IPSS, No bony pain or a backache, with no weight loss, no sign of malignancy on digital rectal examination, post residual urine more than 100ml. DRE was done in all patients, the size of the prostate was varying from grade 1 to grade 4 enlargements according to modified Romero grading by Lodh B et al 9 According to this classification, grade 1 enlargement (easy access to upper limit of prostate), grade 2 enlargement (lateral margin palpable but upper margin was palpated with some difficulty), grade 3 enlargement (upper margin was palpated with marked difficulty) Grade 4 as inability to access the upper limit even with effort, deep depth lateral sulcus (> two finger width), obliteration of median sulcus with rounded posterior surface.…”

Section: Data Collection Proceduresmentioning

confidence: 99%

To determine the frequency of prostate malignancy in patients with clinically benign prostate

Qureshi

Sohail

Sahito³

et al. 2019

TPMJ

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To see the frequency of prostatic malignancy in patients presenting with clinically benign prostate. Study Design: Descriptive case series. Setting: Department of Urology at Peoples University of Medical and Health Sciences for Women / Hospital Nawabshah. Period: Fifteen Months, From October 2016 to December 2017. Materials and Methods: A total of 100 patients who presented with the clinically benign prostate in Urology OPD were enrolled. All concern data regarding Age, mode of presentation (lower urinary tract symptoms with IPSS score/ Acute retention of urine), comorbid, clinical examination findings, pre voided and post-void residual urine determination (on ultrasonography) were entered. The laboratory investigation includes complete blood count, urea, creatinine, random blood sugar (RBS), urine DR and CS, coagulation profile were performed before TURP.TURP performed under spinal anesthesia. After TURP the prostatic tissue chips were sent for histopathology as a routine. Data was analyzed through SPSS Version 20.0. Results: The average age of males was 71.38± 7.19 yrs. Most of the patients with (IPSS 20-35) BPH have lower urinary tract symptoms (both obstructive and irritative). DRE was done in all patients to estimate the size of the prostrate, it was varying from grade 1 enlarged n= 27(27%), grade 2 enlarged n= 36(36%), to grade 3 enlarged in n=37(37%). There were 3 (3%) cases reported to have prostate cancer, with findings confirmed by biopsy of TURP Specimen. There was no mortality seen in our study. The clinical presentation of patients, grades of enlargements on DRE and IPSS however, demonstrated no correlation. Conclusion: BPH is more common between 60-80yrs. When patient undergo TURP or open prostatectomy, every specimen should be sent for biopsy because prostate cancer is only confirmed by biopsy, so that prostate cancer is detected early Radiology & PSA values are supportive in their role but are not true diagnostic. Prostatic cancer is a significant morbid condition, so effective measures should be taken to detect prostatic cancer, so that patient can be properly treated according to the stage.

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Comparative Evaluation of Post-TURP Complications in Patients with BPH Presenting with and Without Acute Urinary Retention

Pogula

Galeti

Ahmad

et al. 2021

International Journal of Recent Surgical and Medical Sciences

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Background Benign prostatic hyperplasia (BPH) is a prevalent urological condition affecting men at an older age. Acute urinary retention (AUR) is a severe symptom of men who develop BPH. TURP is the gold standard as the management of BPH is concerned. Our study tried to compare the post-TURP complications between patients presented with and without AUR. Materials and Methods We enrolled 126 patients, out of which 74 were in the AUR group and 52 in the non-AUR group. The mean age of patients with AUR was 62.51 years, and that for patients without AUR was 61.06 years. Statistical significance was noted in our study in patients with AUR and without AUR regarding the prostate's grading by DRE, the volume of gland, PSA level, post-TURP UTI, recatheterization post TURP, length of hospital stays with p-values 0.000, 0.000, 0.006, 0.004, 0.007, and 0.000, respectively. Statistical significance was not noted in patients with AUR and without AUR with regard to the grading of hypertension, diabetes mellitus, ischemic heart disease, post-op TURP syndrome, post-TURP hematuria, patients needing a blood transfusion, post-TURP sepsis, LUTS, post-TURP stricture, resurgery for clot retention with p values of 0.918, 1.000, 1.000, 1.000, 0.523, 0.642, 1.000, 0.319, 1.000, and 1.000, respectively. Conclusion Our study shows that post-TURP complications such as hematuria, blood transfusion rate, post-op UTI, sepsis, recatheterization, lower urinary tract stricture, resurgery, TUR syndrome, and the length of hospital stay were higher in patients who presented with AUR than in those without AUR. Post-TURP UTI complications, recatheterization rate, and the length of hospital stay were statistically significant in the AUR group compared with the non-AUR group. Therefore, it is better to intervene earlier before the patients develop AUR to minimize the complications and maximize the outcomes.

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Digital rectal grading of benign prostatic hyperplasia: Where does it stand today?

Cited by 5 publications

References 4 publications

Estimation of prostate size by trans-rectal ultrasound and its correlation with DRE and endoscopic grading

Estimation of prostate size by trans-rectal ultrasound and its correlation with DRE and endoscopic grading

To determine the frequency of prostate malignancy in patients with clinically benign prostate

Comparative Evaluation of Post-TURP Complications in Patients with BPH Presenting with and Without Acute Urinary Retention

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