New concept of BPH: PCAR theory

Watanabe, Hiroki

doi:10.1002/(sici)1097-0045(19981001)37:2<116::aid-pros8>3.0.co;2-e

Cited by 33 publications

(36 citation statements)

References 7 publications

(6 reference statements)

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“…We agree with Watanabe (1998) 9 and Ansari et al . (2000) 10 that the inner gland ratio, protrusion into the bladder, and presence of surgical capsule are important factors in the probability of outlet stenosis, increasing in patients with more than two of these criteria.…”

Section: Discussionsupporting

confidence: 93%

“…In 1998 Watanabe 9 reported an important principle explaining the variance of PVR in cases with BPH, as mostly related to the elasticity of the prostatic surgical capsule. By means of conventional TRUS, he referred to only two parameters, measuring of the presumed circle area ratio (PCAR), which is considered a necessary condition and PVR as a sufficient condition.…”

Section: Introductionmentioning

confidence: 99%

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Benign prostatic hyperplasia: Clinical benefits on Three‐Dimensional ultrasound eXtended Imaging (3D‐XI)

Elwagdy¹,

Elhakim²,

Moussa³

et al. 2008

Int J of Urology

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Objectives:To prospectively evaluate whether trans-rectal Three-Dimensional eXtended Imaging (3D XI) allows characterization of the prostate gland in cases of isolated benign prostate hyperplasia (BPH) so as to elucidate the motive for discrepancy of postvoiding residual urine. Methods: The study was conducted according to the standards of the local ethics committee. Patients gave informed consent. Disclosing the 3D XI display of the prostatic urethra and prostatic gland zones was a preliminary essential. The study included 113 men with a clinical diagnosis of BPH in whom transurethral resection of the prostate was planned. Patients aged from 52 to 75 years (mean 63). Other causes of infravesical obstructive uropathy and prostate neoplastic involvement were excluded. All patients were evaluated by three-dimensional Trans-Rectal Ultrasound using 3D XI methods. Patients were grouped according to the postvoiding residual urine volume into three groups, less and more than 100 mL and urine retention. Results: 3D XI provided excellent resolution and diagnostic authority of prostate gland anatomy and for the appraisal of BPH morphology. The balance and type of nodular eruption proved responsible for the severity of symptoms aspires by extra-axial nodular effect upon the prostate urethra. The 3D XI analysis regarding the nodular stromal to glandular ratio compared to the histopathological results proved effectual in 98.3% of stromal-dominant, 100% in glandular-dominant and 93.3% in mixed type hyperplasia. Conclusions:The severity of symptoms among men with BPH showed an association with the nodular credence, highlighted by 3D XI as a supportive tool in characterizing BPH.

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Benign prostatic hyperplasia: Clinical benefits on Three‐Dimensional ultrasound eXtended Imaging (3D‐XI)

Elwagdy¹,

Elhakim²,

Moussa³

et al. 2008

Int J of Urology

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“…Accordingly, previous studies have indicated that the correlation between total prostate volume (TPV) and LUTS severity is relatively modest . Therefore, researchers have searched for other prostatic anatomical factors, such as transitional zone volume (TZV), transitional zone index (TZI), presumed circle area ratio (PCAR), intravesical prostatic protrusion (IPP), and prostatic urethral angulation (PUA) , which are more significantly associated with urinary symptom scores, maximum urinary flow rate (Q max ), and urodynamically confirmed obstruction than TPV.…”

Section: Introductionmentioning

confidence: 99%

“…According to PCAR theory, the normal prostate has a thin triangular shape, which approaches a circle as BPH progresses. When prostate shape becomes closer to a circle, intraprostatic pressure can increase . Recently, Matsugasumi et al.…”

Section: Introductionmentioning

confidence: 99%

Clinical significance of peripheral zone thickness in men with lower urinary tract symptoms/benign prostatic hyperplasia

et al. 2015

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ObjectiveTo evaluate the clinical impact of prostate peripheral zone thickness (PZT), based on presumed circle area ratio (PCAR) theory, on urinary symptoms in men with lower urinary tract symptoms/benign prostatic hyperplasia (LUTS/BPH) as a novel prostate parameter. Patients and methodsMedical records were obtained from a prospective database of first-visit men with LUTS/BPH. Age, international prostate symptom score (IPSS), overactive bladder symptom score (OABSS), maximum urinary flow rate (Q max ), and post-void residual urine volume (PVR) were assessed. Total prostate volume (TPV), transition zone volume (TZV), transition zone index (TZI), and PZT were measured by transrectal ultrasonography. Reliability analysis was also performed. ResultsIn all, 1009 patients were enrolled for the analysis. The mean (SD) PZT was 11.10 (2.50) mm, and patients were classified into three groups PZT thickness groups; PZT <9.5 mm, ≥9.5 to <13 mm, and ≥13 mm. As the PZT became smaller, all urinary symptom scores including IPSS, quality of life (QoL), and OABSS significantly increased. Uroflowmetry variables, such as Q max and PVR, also showed significant differences. PZT showed a high intra-class correlation coefficient (0.896). Multivariate analysis revealed that the PZT was independently associated with IPSS (P < 0.001), QoL (P = 0.003), OABSS (P = 0.001), and PVR (P = 0.001), but PZT influence on Q max was only of borderline significance (P = 0.055). ConclusionPZT is a novel, easy-to-measure prostate parameter that is significantly associated with urinary symptoms. Our present findings suggest that clinical usefulness of PZT should be further validated for managing men with LUTS/BPH.

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“…The parenchymal MER is affected by microvessel counts, vascular density and the interstitial water space [14,18]. Since the intraprostatic pressure may also compress the vasculature and decrease the interstitial water space, we can assume that prostate compressive pressure is inversely correlated to the parenchymal MER, i.e., the prostates with smaller parenchymal MER indicate higher intraprostatic pressure.…”

Section: Discussionmentioning

confidence: 99%

Pharmacokinetic parameters as a potential predictor of response to pharmacotherapy in benign prostatic hyperplasia: a preclinical trial using dynamic contrast-enhanced MRI

Jia

Heverhagen

Henry

et al. 2006

Magnetic Resonance Imaging

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New concept of BPH: PCAR theory

Cited by 33 publications

References 7 publications

Benign prostatic hyperplasia: Clinical benefits on Three‐Dimensional ultrasound eXtended Imaging (3D‐XI)

Benign prostatic hyperplasia: Clinical benefits on Three‐Dimensional ultrasound eXtended Imaging (3D‐XI)

Clinical significance of peripheral zone thickness in men with lower urinary tract symptoms/benign prostatic hyperplasia

Pharmacokinetic parameters as a potential predictor of response to pharmacotherapy in benign prostatic hyperplasia: a preclinical trial using dynamic contrast-enhanced MRI

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